Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX.
OrthoCarolina Hand and Wrist Center, Charlotte, NC.
J Hand Surg Am. 2023 Jun;48(6):626.e1-626.e8. doi: 10.1016/j.jhsa.2022.01.011. Epub 2022 Apr 16.
This study investigated metacarpal fracture occurrences, characteristics, treatments, and return-to-play times for National Football League (NFL) athletes.
NFL players who sustained metacarpal fractures during the 2012 to 2018 seasons were reviewed. All players on the 32 NFL team active rosters with metacarpal fractures recorded through the NFL Injury Database were included. Player age, time in the league, player position, injury setting, injury mechanism, fractured ray, management, and return-to-play were recorded.
There were 208 injury occurrences resulting in 1 or more metacarpal fractures, identified in 205 players. Of these, 81 (39%) injuries were operated. Return-to-play data were available for 173 (83%) injured players. The median return-to-play time for all athletes was 15 days (interquartile range, 1-55 days). Of the injured players, 130 (71%) missed time but returned the same season. Within this 130-player subset, 69 (53%) were treated nonsurgically and 61 (47%) operatively with median return-to-play times of 16 days (interquartile range, 6-30 days) and 20 days (interquartile range, 16-42 days) respectively. Eighteen individuals in this 130-player subgroup sustained a thumb metacarpal fracture. The return-to-play time was slower for patients sustaining thumb metacarpal fractures compared to other metacarpal fractures, and was significantly longer (median, 55 days) following nonsurgical treatment of thumb fractures compared with operative intervention (median, 24 days). A regression analysis revealed no trend or difference in return to football with respect to player age, time in the league, injury setting (practice vs game), injury mechanism, articular involvement, multiple concomitant injuries, or player position.
Most NFL players who sustain metacarpal fractures miss less than 3 weeks and return to play the same season. The only variables that lessen the return-to-play time are involvement of lesser digit metacarpals and operative intervention for treatment of thumb metacarpal fractures.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
本研究调查了美国国家橄榄球联盟（NFL）运动员掌骨骨折的发生情况、特征、治疗方法和重返赛场时间。
对 2012 年至 2018 赛季期间发生掌骨骨折的 NFL 运动员进行了回顾。所有记录在 NFL 伤病数据库中的 32 支 NFL 球队现役名单中有掌骨骨折的球员都包括在内。记录了球员年龄、联盟时间、球员位置、受伤环境、受伤机制、骨折射线、管理和重返赛场。
共有 205 名球员中有 208 次受伤导致 1 处或多处掌骨骨折。其中 81 例（39%）进行了手术。有 173 名（83%）受伤运动员的重返赛场数据可用。所有运动员的中位数重返赛场时间为 15 天（四分位距，1-55 天）。在受伤的运动员中，130 名（71%）球员缺席比赛，但在同一赛季复出。在这 130 名球员中，69 名（53%）球员接受了非手术治疗，61 名（47%）球员接受了手术治疗，中位数重返赛场时间分别为 16 天（四分位距，6-30 天）和 20 天（四分位距，16-42 天）。在这 130 名患者亚组中有 18 名患者发生拇指掌骨骨折。与其他掌骨骨折相比，拇指掌骨骨折患者的重返赛场时间较慢，且非手术治疗的拇指骨折患者的重返赛场时间明显长于手术治疗（中位数分别为 55 天和 24 天）。回归分析显示，无论球员年龄、联盟时间、受伤环境（练习赛与比赛）、受伤机制、关节受累、多处同时受伤或球员位置如何，球员重返足球运动的趋势或差异均无统计学意义。
大多数发生掌骨骨折的 NFL 运动员错过不到 3 周时间，且在同一赛季重返赛场。唯一能缩短重返赛场时间的因素是较小的掌骨和拇指掌骨骨折的手术治疗。
研究类型/证据水平：预后 IV 级。
