Goldfarb Jake H, Randall Zachary D, Pereira Daniel E, Yaeger Lauren, Berkes Marschall B
Washington University School of Medicine, St Louis, MO, USA.
Department of Orthopaedic Surgery, Washington University in St Louis School of Medicine, St Louis, MO, USA.
Foot Ankle Orthop. 2025 May 11;10(2):24730114251337078. doi: 10.1177/24730114251337078. eCollection 2025 Apr.
Open fractures are complex injuries with high complication rates and infection risks, often resulting in prolonged recovery and limited return to physical activities. Despite this, data on return to sport (RTS) or return to military duty (RTD) are limited. This study evaluates RTS or RTD in individuals with lower extremity open fractures, hypothesizing extended recovery times and limited return rates, particularly for amateur athletes and military personnel compared with professional athletes.
A systematic review of studies from 1990 to 2024 was conducted using Embase, Ovid MEDLINE, Clinicaltrials.gov, Cochrane databases, SPORTDiscus, and Scopus. Studies investigating lower extremity open fractures with RTS or RTD outcomes were included. Data extracted included patient demographics, Gustilo-Anderson classifications, recovery timelines, and return rates.
Eleven studies were included, with 10 involving adults and 1 including pediatric patients. The analysis covered 722 open fractures. Two studies reported an average return to sport time of 44.0 weeks (17 individuals) in amateur athletes, whereas 3 studies reported an average return to sport time of 61.8 weeks (26 individuals) in professional athletes. Five studies reported 27.3% of amateur athletes had returned to sports at final follow-up (mean = 19.5 months), and 1 study reported that 18.3% of military members returned to full duty at final follow-up. In the 3 studies reporting on professional athletes, 80.8% returned to playing at the professional level.
Lower extremity open fractures often result in prolonged recovery times and significantly limit RTS or RTD. Although professional athletes demonstrated higher return rates, the outcomes for the general amateur athlete and military populations were substantially poorer. Further research with discrete fracture and treatment details is needed to better understand recovery trajectories for open fractures, disparity in outcomes between professional and amateur athletes, and the influence of resources and motivation on returning to activity.
开放性骨折是复杂的损伤，并发症发生率和感染风险高，常导致恢复时间延长且恢复体力活动受限。尽管如此，关于恢复运动（RTS）或重返军事任务（RTD）的数据有限。本研究评估下肢开放性骨折患者的RTS或RTD情况，假设恢复时间延长且恢复率有限，特别是与职业运动员相比，业余运动员和军事人员的恢复情况更差。
使用Embase、Ovid MEDLINE、Clinicaltrials.gov、Cochrane数据库、SPORTDiscus和Scopus对1990年至2024年的研究进行系统综述。纳入调查下肢开放性骨折并得出RTS或RTD结果的研究。提取的数据包括患者人口统计学信息、 Gustilo-Anderson分类、恢复时间线和恢复率。
纳入11项研究，其中10项涉及成人，1项包括儿科患者。分析涵盖722例开放性骨折。两项研究报告业余运动员平均恢复运动时间为44.0周（17例），而三项研究报告职业运动员平均恢复运动时间为61.8周（26例）。五项研究报告27.3%的业余运动员在末次随访时（平均=19.5个月）恢复运动，一项研究报告18.3%的军事人员在末次随访时恢复全职工作。在三项报告职业运动员情况的研究中，80.8%的人恢复到职业水平比赛。
下肢开放性骨折常导致恢复时间延长，并显著限制RTS或RTD。尽管职业运动员的恢复率较高，但普通业余运动员和军事人群的结果要差得多。需要进一步研究具体的骨折和治疗细节，以更好地了解开放性骨折的恢复轨迹、职业和业余运动员之间结果的差异，以及资源和动机对恢复活动的影响。
