Department of Orthopedic Surgery, Sports Medicine, Stanford University, Stanford, California, USA.
Illinois Bone and Joint Institute, Chicago, Illinois, USA.
Orthop J Sports Med. 2016 Feb 9;4(2):2325967115627623. doi: 10.1177/2325967115627623. eCollection 2016 Feb.
Although a recognized and discussed injury, chondral rib fractures in professional American football have not been previously reported in the literature. There currently exists no consensus on how to identify and treat these injuries or the expected return to play for the athlete.
To present 2 cases of chondral rib injuries in the National Football League (NFL) and discuss the current practice patterns for management of these injuries among the NFL team physicians.
Case series; Level of evidence, 4.
Two cases of NFL players with chondral rib injuries are presented. A survey regarding work-up and treatment of these injuries was completed by team physicians at the 2014 NFL Combine. Our experience in identifying and treating these injuries is presented in conjunction with a survey of NFL team physicians' experiences.
Two cases of rib chondral injuries were diagnosed by computed tomography (CT) and treated with rest and protective splinting. Return to play was 2 to 4 weeks. NFL Combine survey results show that NFL team physicians see a mean of 4 costal cartilage injuries per 5-year period, or approximately 1 case per year per team. Seventy percent of team physicians use CT scanning and 43% use magnetic resonance imaging for diagnosis of these injuries. An anesthetic block is used acutely in 57% and only electively in subsequent games by 39%.
A high index of suspicion is necessary to diagnose chondral rib injuries in American football. CT scan is most commonly used to confirm diagnosis. Return to play can take up to 2 to 4 weeks with a protective device, although anesthetic blocks can be used to potentially expedite return.
Chondral rib injuries are common among NFL football players, while there is no literature to support proper diagnosis and treatment of these injuries or expected duration of recovery. These injuries are likely common in other contact sports and levels of competition as well. Our series combined with NFL team physician survey results can aid team physicians in identifying these injuries, obtaining useful imaging, and counseling players and coaches and the expected time of recovery.
虽然肋软骨骨折是一种公认且已讨论过的损伤，但在专业美式足球中，这种损伤此前并未在文献中报道过。目前，对于如何识别和治疗这些损伤，以及运动员的预期回归赛场，尚无共识。
报告 2 例美国国家橄榄球联盟（NFL）中的肋软骨损伤病例，并讨论 NFL 队医对这些损伤的管理的当前实践模式。
病例系列；证据等级，4 级。
报告 2 例 NFL 球员的肋软骨损伤病例。在 2014 年 NFL 联合会上，对队医进行了关于这些损伤的检查和治疗的调查。我们在识别和治疗这些损伤方面的经验与 NFL 队医经验的调查相结合。
通过计算机断层扫描（CT）诊断出 2 例肋骨软骨损伤病例，并采用休息和保护夹板进行治疗。恢复比赛的时间为 2 至 4 周。NFL 联合调查结果显示，NFL 队医每 5 年平均看到 4 例肋软骨损伤，即每个队每年约 1 例。70%的队医使用 CT 扫描，43%使用磁共振成像（MRI）进行这些损伤的诊断。57%的队医在急性情况下使用麻醉阻滞，而仅 39%的队医在后续比赛中选择性使用。
在美式足球中，必须高度怀疑肋软骨损伤。CT 扫描是最常用于确认诊断的方法。使用保护装置时，恢复比赛可能需要 2 至 4 周，尽管麻醉阻滞可以加速恢复。
肋软骨损伤在 NFL 足球运动员中很常见，但没有文献支持对这些损伤的正确诊断和治疗或预期的恢复时间。这些损伤在其他接触性运动和竞技水平中也可能很常见。我们的病例系列和 NFL 队医调查结果可以帮助队医识别这些损伤，获取有用的影像学结果，并为运动员、教练和预期的康复时间提供咨询。
