Schwab Laura, Warby Sarah, Davis Katherine, Campbell Peter, Hoy Simon, Zbeda Robert, Hoy Gregory
Faculty of Science, Medicine and Health, University of Wollongong, Keiraville, Australia.
Melbourne Shoulder Group, Prahran, Australia.
Orthop J Sports Med. 2022 Aug 24;10(8):23259671221117826. doi: 10.1177/23259671221117826. eCollection 2022 Aug.
There is little evidence regarding the mechanisms of pectoralis major (PM) injury and player outcomes in Australian Football League (AFL) players.
PURPOSES/HYPOTHESIS: The study aims were to investigate (1) the mechanisms of PM muscle injury in elite AFL players via video analysis and (2) the player profile, method of management, and clinical outcomes of the PM injuries sustained. We hypothesized that the majority of PM tears would occur in outer-range PM positions (hyperextension of the glenohumeral joint).
Case series; Level of evidence, 4.
We analyzed video of the precipitating event for traumatic PM injuries during AFL competition or training over a 20-year period (2002-2021). The footage was analyzed by 4 experienced assessors, and the following were evaluated: mechanism of injury, injury variables (arm position, initial contact point, visual awareness, and use of taping), player characteristics (age at the time of injury, hand dominance, and history of injury), injury profile (location and size of tear), method of management (operative vs nonoperative), patient outcomes (time to return to full senior training/match play), and complication rates.
The mean ± standard deviation age of the players was 26.5 ± 3.1 years (range, 21-32 years). Overall, 22 PM injuries were identified in the AFL injury database for a rate of 1.1 per year; 16 of these injuries had accompanying video footage. We identified 3 mechanisms for PM injury: horizontal hyperextension (62.5%), hyperflexion-abduction (25.0%), and horizontal adduction (sustained tackling; 12.5%). The most common site of the tear was the insertion point of the sternocostal head (91.0%). Twenty players (91.0%) required surgical repair, with 75% undergoing surgery within 1 week (range, 0-26 weeks). The mean return to competition for the surgical repair group was 11.1 weeks (range, 8-15 weeks). The rerupture rate was 5.0% (1 repair; <4 weeks postoperatively in 2004).
PM tears in elite male AFL players were due to 1 of 3 distinct mechanisms: horizontal hyperextension, hyperflexion-abduction, and horizontal adduction (sustained tackling). Players returned to play on average 11 weeks after injury. Knowledge regarding mechanisms of injury, player profile, and return-to-sport timelines is important for appropriate medical management and provides potential areas to target for prevention of PM injuries.
关于澳大利亚足球联赛（AFL）球员胸大肌（PM）损伤的机制及球员预后的证据很少。
目的/假设：本研究旨在（1）通过视频分析调查精英AFL球员PM肌肉损伤的机制，以及（2）研究PM损伤球员的个人资料、治疗方法和临床预后。我们假设大多数PM撕裂发生在PM的外展位置（盂肱关节过度伸展）。
病例系列；证据等级，4级。
我们分析了20年期间（2002 - 2021年）AFL比赛或训练期间创伤性PM损伤的诱发事件视频。由4名经验丰富的评估人员对视频进行分析，并评估以下内容：损伤机制、损伤变量（手臂位置、初始接触点、视觉意识和使用胶带情况）、球员特征（受伤时的年龄、惯用手和受伤史）、损伤情况（撕裂的位置和大小）、治疗方法（手术治疗与非手术治疗）、患者预后（恢复全面高级训练/比赛的时间）和并发症发生率。
球员的平均年龄±标准差为26.5±3.1岁（范围为21 - 32岁）。总体而言，在AFL损伤数据库中确定了22例PM损伤，每年发生率为1.1例；其中16例损伤有相关视频资料。我们确定了PM损伤的3种机制：水平过度伸展（62.5%）、过度屈曲外展（25.0%）和水平内收（持续擒抱；12.5%）。最常见的撕裂部位是胸肋头的附着点（91.0%）。20名球员（91.0%）需要手术修复，75%在1周内（范围为0 - 26周）接受手术。手术修复组平均恢复比赛的时间为11.1周（范围为8 - 15周）。再破裂率为5.0%（1例修复；2004年术后<4周）。
精英男性AFL球员的PM撕裂是由3种不同机制之一引起的：水平过度伸展、过度屈曲外展和水平内收（持续擒抱）。球员受伤后平均11周恢复比赛。了解损伤机制、球员个人资料和重返运动的时间线对于适当的医疗管理很重要，并为预防PM损伤提供了潜在的目标领域。
