Singh Sameer K, Larkin Kevin E, Kadakia Anish R, Hsu Wellington K
Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Department of Orthopaedic Surgery, University of Arizona, Tucson, Arizona.
Sports Health. 2018 Jan-Feb;10(1):70-74. doi: 10.1177/1941738117729660. Epub 2017 Sep 15.
Professional athletes are predisposed to fractures of the foot due to large stresses placed on the lower extremity. These players are concerned with efficiently returning to play at a high level. Return-to-play rates after operative treatment have been previously reported, yet performance outcomes after such treatment are generally unknown in this population.
Overall, professional athletes sustaining a foot fracture would return to play at high rates with little impact on postoperative performance or league participation. However, National Football League (NFL) athletes would have a significantly greater decline in performance due to the high-impact nature of the sport.
Case series.
Level 4.
Athletes in the National Basketball League (NBA), NFL, Major League Baseball (MLB), and National Hockey League (NHL) undergoing operative fixation of a foot fracture were identified through a well-established protocol confirmed by multiple sources of the public record. Return-to-play rate and time to return were collected for each sport. League participation and game performance data were collected before and after surgery. Statistical analysis was performed, with significance accepted as P ≤ 0.05.
A total of 77 players undergoing 84 procedures met the inclusion criteria. Overall, 98.7% (76/77) of players were able to return to play, with a median time to return across all sports of 137 days. Players returned to preoperative performance levels within 1 season of surgery. Six players (7.8%) sustained refracture requiring reoperation, all of whom were in the NBA. Percentage of games started during the season after primary operative treatment was a predictive factor for reinjury (99% vs 40%, P = 0.001).
Athletes returned to play at a high rate after foot fracture fixation, with excellent postoperative performance levels, regardless of sport and fracture location. NBA athletes sustaining fifth metatarsal and navicular fractures are at greater risk of reinjury compared with other athletes. Returning to high levels of athletic participation soon after surgery may predispose athletes to refracture and subsequent reoperation.
Players, coaches, and team physicians should be aware of the impact of foot fractures on career performance and longevity to best guide therapy.
职业运动员由于下肢承受巨大压力，足部易发生骨折。这些运动员关心能否高效地高水平重返赛场。此前已有关于手术治疗后重返赛场率的报道，但该人群接受此类治疗后的表现结果通常尚不清楚。
总体而言，足部骨折的职业运动员将以较高比例重返赛场，对术后表现或联赛参赛影响不大。然而，由于橄榄球运动的高冲击性，美国国家橄榄球联盟（NFL）的运动员在表现上会有显著更大幅度的下降。
病例系列研究。
4级。
通过经公共记录的多个来源证实的既定方案，确定美国职业篮球联赛（NBA）、NFL、美国职业棒球大联盟（MLB）和国家冰球联盟（NHL）中接受足部骨折手术固定的运动员。收集每项运动的重返赛场率和重返时间。收集手术前后的联赛参赛情况和比赛表现数据。进行统计分析，以P≤0.05为有统计学意义。
共有77名运动员接受了84次手术，符合纳入标准。总体而言，98.7%（76/77）的运动员能够重返赛场，所有运动项目的中位重返时间为137天。运动员在手术后1个赛季内恢复到术前表现水平。6名运动员（7.8%）发生再次骨折需要再次手术，均来自NBA。初次手术治疗后赛季中首发比赛的百分比是再次受伤的预测因素（99%对40%，P = 0.001）。
足部骨折固定术后运动员重返赛场的比例较高，术后表现水平良好，无论运动项目和骨折部位如何。与其他运动员相比，NBA中第五跖骨和舟骨骨折的运动员再次受伤的风险更高。手术后不久就恢复高水平的运动参与可能会使运动员易发生再次骨折及随后的再次手术。
运动员、教练和队医应了解足部骨折对职业生涯表现和运动寿命的影响，以便更好地指导治疗。
