Summary

We assessed outcome and return to sport performance in elite footballers (Australian Rules) and found excellent performance but a significant number of bent plates with early play.

Abstract

The aim of the present study was to retrospectively review the results, return to sport and performance level after clavicle fracture fixation in a consecutive series of senior professional Australian Rules Football players competing in the Australian Football League (AFL).

Methods

Of 103 fractures operated over a 13 year period using a commercial pre-contoured titanium plate and a mix of locking and non-locking screws, 13 were performed in elite professional AFL players. Two players were playing at lower level and one was placed on the long term injury list, leaving a total of ten players analysed for post-operative success, return to high level collision sport, and performance scores in their first games after return to play. At a minimum follow-up of 12 months Nottingham Clavicle Score (NCS), Oxford Shoulder scoring System (OSS) and Subjective Shoulder Value (SSV) were evaluated.

Results

Average (median) time of return to play was 3 weeks for injuries that happened during the season. The game involvement (amount of kicks, marks, handballs and tackles) as well as player performance scores did not significantly change after surgery. AFL Fantasy scores were followed with acceptable performance post-injury. Despite these results, three players had further injury before bony union with a bent plate being found at that time or later. One required re-operation, although several requested plate removal at a later time in the off-season.

Conclusions

In a collective of professional Australian rules football players, an early return to collision sport after clavicle plating could be achieved without clinical compromise. Players with in-season fractures were capable of early return, (earlier than previously published), but with three players (30%) suffering a bent plate despite early return. We feel we are pushing the envelope of acceptable return to play acceleration to its limit with this program.