Brooks Kendall, Orchard John W, Saw Anna E, Kountouris Alex
Alphington Sports Medicine Clinic, 339 Heidelberg Rd, Northcote, VIC, Australia.
Cricket Australia, 60 Jolimont St, Jolimont, VIC, Australia.
J Orthop. 2020 Mar 26;22:100-103. doi: 10.1016/j.jor.2020.03.039. eCollection 2020 Nov-Dec.
Hand fractures are one of the most common injuries sustained whilst playing cricket. Further research is required to inform future clinical management and risk-reduction strategies.
This retrospective cohort study reviewed all cases of hand fractures in elite Australian cricket players over a three-year period. Data included specific activity when injury occurred, location of injury, management (non-surgical or surgical) and days to return to play.
Seventy (17%, 95% CI 14-21 of players; 43 male, 27 female) players sustained 90 hand fractures. Seventy-three (81%, 95% CI 72-89) fractures occurred whilst fielding the ball. Eighty-four (93%, 95% CI 86-97) fractures occurred to the 'exterior' bones of the hand: distal phalanx, middle phalanx, first and fifth rays. Thirteen (14%, 95% CI 9-23) fractures were managed with surgical internal fixation, of which 11 were to the phalanges, most commonly at the proximal phalanx (n = 5, 36% of all proximal phalanx fractures) or fifth ray middle and proximal phalanges (n = 5, 42% of all fifth ray phalangeal fractures). Fractures requiring surgical management typically had longer time injured (median 33 days, IQR 27-41) than fractures managed non-surgically (median 6 days, IQR 0-21) (p = 0.001). Total time to return to full unrestricted play was similar between surgical (49 days, IQR 45-52) and non-surgical (32 days, IQR 15-45) management (p = 0.197).
Hand fractures sustained by elite male and female Australian cricket players were found to display a pattern of occurring to the 'exterior' bones of the hand. The results of this study may inform clinical decision making with respect to non-surgical or surgical management and anticipated return to play times. Further effort is needed to address risk reduction strategies including gloves and skill proficiency.
手部骨折是板球运动中最常见的受伤类型之一。需要进一步研究以指导未来的临床管理和降低风险策略。
这项回顾性队列研究对澳大利亚精英板球运动员在三年期间的所有手部骨折病例进行了回顾。数据包括受伤时的具体活动、受伤部位、治疗方式（非手术或手术）以及恢复比赛的天数。
70名（占球员的17%，95%置信区间为14 - 21；43名男性，27名女性）球员发生了90例手部骨折。73例（81%，95%置信区间为72 - 89）骨折发生在接球时。84例（93%，95%置信区间为86 - 97）骨折发生在手的“外侧”骨骼：远端指骨、中间指骨、第一和第五掌骨。13例（14%，95%置信区间为9 - 23）骨折采用手术内固定治疗，其中11例为指骨骨折，最常见于近端指骨（n = 5，占所有近端指骨骨折的36%）或第五掌骨的中间和近端指骨（n = 5，占所有第五掌骨指骨骨折的42%）。需要手术治疗的骨折通常受伤时间更长（中位数33天，四分位间距27 - 41），而非手术治疗的骨折受伤时间中位数为6天（四分位间距0 - 21）（p = 0.001）。手术治疗（49天，四分位间距45 - 52）和非手术治疗（32天，四分位间距15 - 45）恢复到完全不受限制比赛的总时间相似（p = 0.197）。
发现澳大利亚精英男女板球运动员手部骨折呈现出发生在手“外侧”骨骼的模式。本研究结果可为非手术或手术治疗以及预期恢复比赛时间的临床决策提供参考。需要进一步努力制定包括手套和技能熟练程度在内的降低风险策略。
