2017 ISAKOS Biennial Congress ePoster #2601

 

Early Unprotected Return to Play After Metacarpal Fixation in Professional Contact Athletes

Gregory A. Hoy, FRACS, FAOrthA, FACSP, FASMF, Melbourne, VIC AUSTRALIA
Matthew Yalizis, FRACS, Sydney, NSW AUSTRALIA
Hamish Anderson AUSTRALIA
Eugene T.H. Ek, MBBS (Hons), PhD, FRACS (Ortho), Melbourne, Victoria AUSTRALIA

Melbourne Orthopaedic Group, Dept of Surgery Monash University, Melbourne, Victoria, AUSTRALIA

FDA Status Cleared

Summary

Internal fixation with solid plates allows aggressive return to professional sport time lines following metacarpal fractures.

Abstract

Aim

To examine the clinical and functional outcomes of an aggressive surgical protocol developed in order to facilitate early return to sport in a cohort of professional contact athletes (Australian Rules footballers) with metacarpal fractures.

Methods

A retrospective analysis was performed of all consecutive professional Australian Rules Football (AFL) players who had undergone open reduction and internal fixation of a non thumb metacarpal over a ten year period between 2004-2014. Only patients who were current players in the AFL were included.
During the study period, a total of 13 patients were identified as having a non thumb metacarpal fracture and underwent open reduction and internal fixation by the senior author (GAH). All fixation was with a 2.0mm plate and screw construct.
The 13 patients had a latest mean follow up of 58 months (range, 2-126 months). The mean age at time of surgery was 25 years (range, 21-30 years).
The time taken for the patients to return to play was recorded as were all player intra-game statistics. These details were recorded on a National AFL player database which was maintained by AFL Australia.
The final clinical review was conducted by phone interview and included administration of the QuickDASH (Disabilities of the Arm, Shoulder, Hand) questionnaire.

Results

9 out of 13 (69%) patients sustained their fractures during the AFL season and hence return to play was calculable. The average time to return to play was 2.0 weeks (±1.0 week). For the remaining 4 patients who sustained their fractures during the off season, the average return to contact training sessions was 3.0 weeks (±1.7 weeks).

For the patients who sustained their fracture during the AFL season, there was no statistically significant difference detected between the patient’s performance immediately pre-injury and post-fixation. There was one exception which was the number of kicks which one patient performed during the game which reduced to an average of 5.44 from 8.33 pre-injury (p=0.02).

Conclusions

The surgical protocol utilised in this series proved to significantly decrease the return to unprotected play in professional athletes without compromising their clinical outcomes or game performance.