Kodama Narihito, Takemura Yoshinori, Ueba Hiroaki, Imai Shinji, Matsusue Yoshitaka
Department of Orthopaedic Surgery, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan,
J Orthop Sci. 2014 Sep;19(5):729-36. doi: 10.1007/s00776-014-0584-5. Epub 2014 Jun 10.
Evaluating the outcomes of operative treatment for metacarpal and phalangeal fractures in athletes returning early to play and discussing the more effective methods that permit rapid early return to athletic activity.
We retrospectively identified a total of 105 metacarpal or phalangeal fractures in 105 athletes with conservative or operative treatment in our department. Of these, 20 athletes required an early return to sport because of a pending important game in their competition within 1 month after injury. Therefore, they underwent surgical treatment with open reduction and internal fixation of metacarpal or phalangeal fractures in an attempt to achieve an early return to their chosen sport at their usual competitive level. The patients included 6 rugby football players, 2 soccer goalkeepers, 3 American football players, 3 handball players, 2 baseball players and 4 who participated in other sports. The clinical records of preoperative and postoperative radiographs were available for all patients, and clinical outcome was evaluated by total active motion (TAM).
The patients were followed up for a mean of 27 (24-43) months. At the latest follow-up examination, bone union was obtained in all cases. In cases with metacarpal and phalangeal fractures, the average TAM was 263° (range 240°-270°).
We consider that an early comeback to training and competition can be permitted exclusively for patients with metacarpal and phalangeal fractures. It is important for the attending physician to administer such treatment after obtaining informed consent and develop a trusting relationship with the patient and other related individuals while paying attention to their hope of quick recovery.
评估掌骨和指骨骨折运动员早期重返赛场的手术治疗效果，并探讨能使运动员快速早期恢复运动的更有效方法。
我们回顾性分析了我科105例接受保守或手术治疗的掌骨或指骨骨折运动员。其中，20名运动员因伤后1个月内有重要比赛而需要提前重返运动。因此，他们接受了掌骨或指骨骨折切开复位内固定手术治疗，以期在其通常的竞技水平上尽早重返所选运动项目。患者包括6名橄榄球运动员、2名足球守门员、3名美式足球运动员、3名手球运动员、2名棒球运动员以及4名参加其他运动的运动员。所有患者均有术前和术后X线片的临床记录，并通过总主动活动度（TAM）评估临床疗效。
患者平均随访27（24 - 43）个月。在最近一次随访检查时，所有病例均获得骨愈合。掌骨和指骨骨折病例的平均TAM为263°（范围240° - 270°）。
我们认为，仅掌骨和指骨骨折患者可允许早期恢复训练和比赛。主治医生在获得知情同意后进行此类治疗，并与患者及其他相关人员建立信任关系，同时关注他们快速康复的期望，这一点很重要。
