棒球运动员钩状骨切除术后的重返赛场
Return to Play After Hook of Hamate Excision in Baseball Players.
作者信息
Burleson Andrew, Shin Steven
机构信息
Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, USA.
出版信息
Orthop J Sports Med. 2018 Oct 17;6(10):2325967118803090. doi: 10.1177/2325967118803090. eCollection 2018 Oct.
BACKGROUND
Fractures of the hook of hamate in baseball players are significant injuries that can lead to pain and missed time from competition. The diagnosis is typically delayed because of the vagueness of symptoms and normal radiographic findings. Excision of the nonunited fragment has been supported as the primary treatment, but there are currently limited information and data on a timetable for return to competition after surgery.
PURPOSE
To report on a large cohort of competitive baseball players with hook of hamate fractures treated with excision of the fragment and to assess the timetable for return to full athletic competition.
STUDY DESIGN
Case series; Level of evidence, 4.
METHODS
Competitive baseball players treated between 2012 and 2017 with hook of hamate excision for acute fractures or chronic fracture nonunions were retrospectively identified. All patients were treated by the same surgeon, and the time to return to full athletic competition was assessed. Return to play was defined as reaching the athlete's preinjury level and being able to perform full sport activities.
RESULTS
A total of 41 baseball players were identified, all of whom were documented to have a chronic presentation of a nonunion or partial union. The population consisted completely of male athletes, with a median age of 21 years (range, 18-34 years). All patients were competitive athletes, with 12 professional baseball players, 17 collegiate baseball players, and 12 high school baseball players. All patients were treated with hook of hamate excision, with 7 patients undergoing concomitant procedures as indicated. The median time to return to play was 5 weeks (range, 3-7 weeks). The time to return to play was similar between professional, collegiate, and high school athletes. All athletes returned to their preinjury level of activity by 7 weeks postoperatively.
CONCLUSION
This study confirms that excision of the fractured hook provides predictable, early return to play, with a limited complication rate.
背景
棒球运动员钩骨钩骨折是一种严重损伤，可导致疼痛并使运动员错过比赛时间。由于症状不明确且X线检查结果正常，诊断通常会延迟。切除未愈合的骨折块被认为是主要治疗方法，但目前关于术后恢复比赛时间安排的信息和数据有限。
目的
报告一大群接受骨折块切除治疗的钩骨钩骨折的竞技棒球运动员，并评估其完全恢复体育比赛的时间安排。
研究设计
病例系列；证据等级，4级。
方法
回顾性确定2012年至2017年间接受钩骨钩切除治疗急性骨折或慢性骨折不愈合的竞技棒球运动员。所有患者均由同一位外科医生治疗，并评估其完全恢复体育比赛的时间。恢复比赛定义为达到运动员受伤前的水平并能够进行完整的体育活动。
结果
共确定41名棒球运动员，所有患者均记录为慢性骨折不愈合或部分愈合。研究对象全部为男性运动员，中位年龄21岁（范围18 - 34岁）。所有患者均为竞技运动员，其中职业棒球运动员12名，大学棒球运动员17名，高中棒球运动员12名。所有患者均接受钩骨钩切除治疗，7例患者根据需要进行了联合手术。恢复比赛的中位时间为5周（范围3 - 7周）。职业、大学和高中运动员恢复比赛的时间相似。所有运动员在术后7周均恢复到受伤前的活动水平。
结论
本研究证实，切除骨折的钩骨钩能使运动员可预测地早日恢复比赛，且并发症发生率有限。
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