• faam (foot and ankle ability measure)
• foot and ankle fracture
• foot injury
• orthopaedic
• orthopaedic department
• sports medicine
• toe fracture
• toe injury
• vfc
• virtual fracture clinic

• athlete
• basketball
• fracture
• sports
• wrist

• Athletes
• Athletic Performance
• Musculoskeletal Diseases
• Physical Fitness

• Humans
• Prevalence
• Athletes/psychology
• Musculoskeletal Diseases/diagnosis
• Musculoskeletal Diseases/epidemiology
• Musculoskeletal Diseases/therapy

• clavicle
• clavicle fracture
• clavicle surgery
• displacement
• figure-of-eight bandage
• midshaft clavicle fracture
• shortening

• Acute
• Fracture
• Phalanx
• Rate
• Return
• Sport
• Stress
• Time
• Toe

• Epidemiology
• Shoulder
• Soccer
• Sports
• Upper limb

• Ankle
• Displacement
• Fracture
• Gravity assisted
• Reduction

• ankle fractures
• conservative management
• rehabilitation
• return to sport
• surgical management
• trauma

• Fracture
• Prevention
• Soccer
• Sport
• Treatment

• Soccer
• UEFA
• patella fracture
• return to play

There is a paucity of information on rate and time to return to play (RTP) in elite-level soccer players who have sustained foot fractures.

To (1) determine the rate and timing of RTP after foot fracture (eg, tarsal, metatarsal, or phalangeal), (2) investigate foot fracture reinjury incidence after RTP, and (3) evaluate performance after foot fracture as compared with matched, uninjured controls.

Descriptive epidemiology study.

Athletes sustaining foot fractures were identified across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2000 and 2016. Injured athletes were matched to controls (1:1) using demographic characteristics and performance metrics from 1 season before injury. The authors recorded RTP rate, reinjury incidence, player characteristics associated with RTP within 2 seasons of injury, player availability, field time, and performance metrics during the 4 seasons after injury.

A total of 192 elite soccer players sustaining a foot fracture were identified; 40 players (20.8%) underwent operative treatment. Athletes missed an average of 69.41 ± 59.43 days and 5.15 ± 23.28 games. In the 4 seasons after injury, 80% of players returned to play, with 72% returning to play within 1 season of injury. Nine players (5%) sustained a subsequent foot fracture. Athletes with a foot fracture demonstrated significantly longer league retention compared with uninjured controls (P < .001). Elite soccer players older than 30 years of age were less likely to RTP (odds ratio, 0.67; P = .002), whereas career experience, field position, and baseline performance showed no significant association with RTP rates. Injured athletes demonstrated similar performance to controls during the 4 years after injury, and there were no position-dependent differences on subgroup analysis. The players who underwent operative treatment had more assists per 90 minutes and more team points per game during the first season after injury compared with athletes treated nonoperatively.

Foot fractures in elite soccer players resulted in moderate loss of play time (69.41 days). RTP rates were high at 80%, although players older than 30 years of age were less likely to RTP. On RTP, athletes who sustained a foot fracture maintained performance similar to preinjury levels and to uninjured controls.

Soccer is the most common team sport in the world. A significant number of players are associated with a large number of injuries. Injuries occur in a variety of contexts regardless of the age or performance level of players. The vast majority of injuries involve soft tissues. Bone injuries are less common, but usually result in long-term exclusion from the game. Three different types of fractures related to soccer are classified as acute types, stress fractures and avulsion. This manuscript outlines the diagnostic procedures and treatments for stress fractures, avulsion fractures and bone cyst. The common feature of the described injuries includes frequent difficulties associated with the correct diagnosis and treatment direction. In therapeutic treatment, the doctor and the patient often have to choose between conservative treatment and surgical treatment, which in many cases is not simple. We suggest that in the event of injuries to soccer players, surgical treatment should be used, shortening the time to return to full sports activity. A very important element of the therapeutic process is proper rehabilitation, which should be individually tailored to the patient in order to optimize the treatment process. Some of the rehabilitation protocols should be permanently incorporated into the warm-up protocols for training. Such a procedure has a preventive effect.

• avulsion fracture
• bone cyst
• sports injuries
• stress fracture

Lower extremity injuries occur with high frequency in National Football League (NFL) athletes and cause high burden to players and teams. Tibial fractures are among the most severe lower extremity injuries sustained in athletes and are associated with prolonged time loss from sport.

To determine the number of tibial fractures in NFL athletes from the 2013 to 2019 NFL seasons and describe athlete demographics, fracture characteristics, and details of injury onset.

Case series; Level of evidence, 4.

A retrospective review of the NFL injury database was performed to identify all NFL athletes sustaining tibial fractures over the 2013 to 2019 NFL seasons. Athlete characteristics, injury characteristics, days missed, and treatment (operative vs nonoperative) were examined. Descriptive statistics were used to calculate means, standard deviations, ranges, and percentages.

A total of 64 tibial fractures were identified in 60 athletes, resulting in a median loss of 74 days. Defensive secondary athletes had the highest number of injuries (n = 10; 16%), followed by running backs (n = 9; 14%), while 61% of these injuries occurred during NFL regular-season games, primarily between weeks 13 and 17. The most commonly reported activity during injury was athletes being tackled, with a direct impact to the tibia being the most common mechanism of injury. Lateral tibial plateau fractures were the most frequently reported, while distal tibial fractures resulted in the greatest number of days lost. The median time lost for injuries requiring surgery was 232 days compared with 56 days for injuries treated using conservative management.

The highest proportion of tibial fractures were injuries to defensive secondary athletes and athletes being tackled while sustaining a direct impact to the leg, primarily to the lateral tibial plateau. Tibial fracture injuries were commonly sustained during NFL regular-season games, primarily during the final 4 weeks of the NFL regular season. Further investigations examining performance and career longevity in athletes sustaining tibial fractures are warranted to help improve the health and safety of NFL athletes.

• American football
• athlete
• fracture
• plateau
• tibia

The average professional soccer team experiences 1 to 2 traumatic leg fractures per season, with unknown effects on player performance.

To (1) determine the rate and time to return to play (RTP) following leg fracture, (2) investigate the rate of reinjury following RTP, and (3) investigate long-term effects that lower extremity (LE) fracture may have on elite soccer player performance.

Cohort study; Level of evidence, 3.

Using publicly available records, we identified athletes sustaining a traumatic leg fracture across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2000 and 2016. Athletes with leg fracture (femur, tibia, and/or fibula) were matched 1:2 to controls by demographic characteristics and performance metrics 1 season before the index timepoint. Investigations included the RTP rate, reinjury rate, player characteristics associated with RTP within 2 seasons, long-term player retention, performance metrics during the 4 following seasons, and subgroup analysis by player position.

A total of 112 players with LE fracture and 224 controls were identified. Players with LE fractures were absent for a mean of 157 days (range, 24-601 days) and 21 games (range, 2-68 games). The rate of RTP within 1 season was 80%, with 4% experiencing subsequent refracture. Injured players remained active in the league at a higher rate than their uninjured counterparts. As compared with controls, injured athletes played 309 fewer total minutes (P < .05), scored 0.09 more assists per game (P < .01) 1 season after injury, and scored 0.12 more points per game 4 seasons after injury (P < .01). Defenders were most affected by an LE fracture, playing 5.24 fewer games (P < .05), 603 fewer total minutes (P < .01), and recording 0.19 more assists per 90 minutes of play as compared with controls 1 season after injury (P < .001). Attackers and midfielders demonstrated no significant difference in metrics after RTP when compared with controls.

Most players sustaining an LE fracture returned to elite soccer at the same level after a significant loss of playing time, with a 4% rate of refracture. Player retention was higher for those sustaining an LE fracture versus uninjured controls. Overall, injured players did not experience a decline in performance after recovery from an LE fracture.

• case-control
• football (soccer)
• general sports trauma
• lower extremity fracture
• performance outcomes

• athletic injuries
• football
• goalkeeper
• injury incidence
• upper extremity

• Athletic injury
• Distal radius fracture
• Sports
• Surgery
• Wrist

• Adolescent
• Child
• Clavicle/injuries
• Clavicle/surgery
• Conservative Treatment/methods
• Female
• Fracture Dislocation/diagnostic imaging
• Fracture Dislocation/rehabilitation
• Fracture Dislocation/surgery
• Fracture Fixation, Internal/methods
• Fracture Healing/physiology
• Fractures, Bone/diagnostic imaging
• Fractures, Bone/rehabilitation
• Fractures, Bone/surgery
• Humans
• Male
• Prognosis
• Recovery of Function

• T32 GM128596 NIGMS NIH HHS

• Athletic Performance
• Clavicle/injuries
• Football/injuries
• Fractures, Bone/diagnosis
• Fractures, Bone/therapy
• Humans
• Male
• Retrospective Studies
• Return to Sport
• Time Factors
• United States

Scaphoid fracture is the most commonly fractured carpal bone in the athletic patient, accounting for over 85% of all sport-related carpal bone fractures, and is particularly common in sports involving high impact injuries to the wrist. The management of such injuries comprises both conservative and surgical techniques, as guided by fracture location and type. Athletes demonstrate a unique challenge with regards to the management of scaphoid fractures due to their requirement to return to sport, as soon as able.

To review systemically all studies recording return to sport following scaphoid fractures, to collate information on return rates to sport (RRS) and mean return times (RTS) to sport and to determine differences in sporting outcome for the various treatment methods.

A systematic search of MEDLINE, EMBASE, CINAHAL, Cochrane, Google Scholar, Physiotherapy Evidence Database, SPORTDiscus, Web of Science and Scopus was performed in August 2018 using the keywords “scaphoid”, “fracture”, “acute”, “carpal”, “athletes”, “sports”, “non-operative”, “conservative”, “operative” and “return to sport”. All studies that recorded RRS and RTS following scaphoid fractures were included. RTS was recorded as the length of time from commencement of either primary conservative management or primary surgical procedure to return to sport.

Eleven studies were included: Two randomised controlled trials, six retrospective cohort studies and three case series. Seven studies reported on conservative management (n = 77), and eight studies reported on surgical management (n = 83). For conservative management, RRS was 90% (69/77), and the mean RTS was 9.6 wk. Three studies allowed to return to sport in cast [RRS 89% (25/28); RTS 1.9 wk], and four studies required completion of cast treatment prior to returning to sport [RRS 90% (44/49); RTS 13.9 wk]. Four studies recorded fracture union data: Union rate 85% (47/55); mean time to union 14.0 wk. For surgical management, RRS was 98% (81/83), and RTS was 7.3 wk. Three studies reported on Percutaneous Screw Fixation [RRS 97% (32/33); RTS 6.5 wk], and five studies reported on Open Reduction Internal Fixation [RRS 98% (49/50); RTS 7.9 wk]. Six studies recorded fracture union data: Union rate 97% (69/71); mean time to union 9.8 wk. On meta-analysis, RRS (RR = 1.09; 95% confidence interval (CI): 1.00-1.18; P < 0.045), RTS (MD 2.3 wk; 95%CI: 0.79-3.87; P < 0.002), union rates (RR = 1.14; 95%CI: 1.01-1.28; P < 0.030) and mean times to union (MD 4.2 wk; 95%CI: 3.94-4.36; P < 0.001) were all significantly better for the surgical cohort compared to the conservative cohort.

Surgical management of scaphoid fractures can provide significantly improved RRS and RTS to sport compared to conservative management. Both treatments, however, remain acceptable options, and athletes should be fully informed of the benefits and risks of both prior to deciding treatment plans. Immediate return to sport in a cast should be avoided due to the significant risk of non-union.

• Acute
• Fracture
• Scaphoid
• Carpal
• Return
• Sport
• Rate
• Time

• Athlete fracture
• Clavicle fracture
• Glenoid fracture
• Mid-shaft humeral fracture
• Scapula fracture

• adolescent
• child
• fracture
• sports
• traumatic

• Adolescent
• Age Factors
• Athletic Injuries/classification
• Athletic Injuries/epidemiology
• Child
• China/epidemiology
• Female
• Fractures, Bone/classification
• Fractures, Bone/epidemiology
• Humans
• Male
• Retrospective Studies
• Sex Factors

Understanding the risks and trends of soccer-related injuries may prove beneficial in creating preventative strategies against season-ending injuries.

Soccer-related fractures will have decreased over the past 7 years.

Descriptive epidemiology study.

Level 3.

The National Electronic Injury Surveillance System (NEISS) database was queried to identify soccer-related injuries from 2010 through 2016. The sum of the weighted values provided in the NEISS database was used to determine injury frequency and allowed us to estimate the incidence and annual trends of soccer-related fractures. The estimated annual number of hospital admissions resulting from each fracture location was calculated. Statistical analyses were performed, and a linear regression was used to analyze the annual injury trends, reported as the correlation coefficient.

Over the 6-year period, there were an estimated 1,590,365 soccer-related injuries. The estimated annual frequency of soccer-related injuries slightly increased from 225,910 in 2010 to 226,150 in 2016 (P = 0.477). The most common injuries were sprains/strains (32.4%), followed by fractures (20.4%). Fractures at the wrist were the most common (18%), while upper leg fractures were the most common soccer-related fractures to be admitted to the hospital (51.6%). The annual trends of the most common soccer-related fractures demonstrated increases in shoulder (r = 0.740; R² = 0.547; P = 0.057) and wrist (r = 0.308; R² = 0.095; P = 0.502) fractures. There were no significant changes in the trends of soccer-related fractures of the lower arm (r = 0.009; R² = 7.3 × 10⁻⁵; P = 0.986), finger (r = 0.679; R² = 0.460; P = 0.094), lower leg (r = 0.153; R² = 0.024; P = 0.743), ankle (r = 0.650; R² = 0.422; P = 0.114), toe (r = 0.417; R² = 0.174; P = 0.353), or foot (r = 0.485; R² = 0.235; P = 0.270).

Despite the reported growing number of soccer players in the United States, the overall number of soccer-related injuries has remained relatively stable. Overall, 60% of reported fractures occurred in the upper extremity, with the wrist being the most common site, while lower extremity fractures were the most likely to lead to hospital admission.

This study offers an overview of the most common types of fractures that affect soccer players and may prove beneficial in creating preventative strategies against season-ending injuries.

• epidemiology
• fractures
• soccer
• trends

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Child, Preschool
• Emergency Service, Hospital
• Female
• Fractures, Bone/epidemiology
• Fractures, Bone/prevention & control
• Humans
• Incidence
• Lower Extremity/injuries
• Male
• Middle Aged
• Risk Factors
• Soccer/injuries
• Sprains and Strains/epidemiology
• United States/epidemiology
• Upper Extremity/injuries
• Young Adult

• NEISS
• epidemiology
• soccer
• upper extremity

• Adolescent
• Athletic Injuries/epidemiology
• Databases, Factual
• Female
• Humans
• Male
• Soccer/injuries
• United States/epidemiology
• Upper Extremity/injuries
• Young Adult

• Adult
• Athletic Performance
• Case-Control Studies
• Clavicle/injuries
• Football/injuries
• Humans
• Male
• Recovery of Function
• Return to Sport/statistics & numerical data
• Shoulder Fractures/therapy

To describe the epidemiology of sport-related open fractures from one centre’s adult patient population over a 15-year period.

A retrospective review of a prospectively-collected database was performed: The database contained information all sport-related open fractures, sustained from 1995 to 2009 in the Edinburgh, Mid and East Lothian Populations.

Over the 15-year period, there were 85 fractures recorded in 84 patients. The annual incidence of open sport-related fractures was 0.01 per 1000 population. The mean age at injury was 29.2 years (range 15-67). There were 70 (83%) males and 14 females (17%). The 6 most common sports were soccer (n = 19, 22%), rugby (n = 9, 11%), cycling (n = 8, 9%), hockey (n = 8, 9%); horse riding (n = 6, 7%) and skiing (n = 6, 7%). The five most common anatomical locations were finger phalanges (n = 30, 35%); tibial diaphysis (n = 19, 23%); forearm (n = 12, 14%); ankle (n = 7, 8%) and metacarpals (n = 5, 6%). The mean injury severity score was 7.02. According to the Gustilo-Anderson classification system, 45 (53%) fractures were grade 1; 28 (33%) fractures were grade 2; 8 (9%) fractures were grade 3a; and 4 (5%) fractures were grade 3b. Out of the total number of fractures, 7 (8%) required plastic surgical intervention as part of management. The types of flaps used were split skin graft (n = 4), fasciocutaneous flaps (n = 2); and adipofascial flap (n = 1).

We analysed the epidemiology of open fractures secondary to sport in one centre over a 15-year period. Soccer and rugby were the most common causative sports while fractures of the finger phalanx and of the tibial diaphysis were the most common sites. Open fractures are uncommon in sport; however, when they are sustained they usually occur on muddy sport fields or forest tracks and therefore must be treated appropriately. It is important that clinicians and sports therapists have knowledge of these injuries, in order to ensure they are managed optimally.

• Open
• Fracture
• Sport
• Epidemiology
• Injury
• Trauma

• Athlete
• Distal radius
• Fracture
• Rehabilitation
• Sport
• Surgery

This EuroSciCon Sports Science Summit represented a significant gathering of leading professionals in the field of sports science. The conference was held on 13–15 January 2015 at the O2 arena, London, UK. The chairman on the third day was Mr Greg Robertson, a specialist trainee Orthopedic surgeon from Edinburgh. The conference attracted over 80 attendants from all over the world, with 32 presentations from invited speakers and peer-reviewed submissions. This meeting report provides a summary of the best abstracts from the conference.

• EuroSciCon
• conference
• exercise
• physiology
• sports science

To evaluate the prevalence of clavicle fractures in professional and amateur cyclists and evaluate the factors associated with its occurrence.

One hundred and forty professional and amateur athletes were interviewed through a questionnaire regarding age and time practicing bicycling, among others.

Among the 140 evaluated cyclists, there were 19 (13.5%) clavicle fractures associated with this sports modality.

There was a positive association between time practicing bicycling and frequency of clavicle fractures, as well as between hours of weekly training and clavicle fractures. Level of Evidence IV, Case-Series.

• Fractures
• bone. Clavicle. Athletic injuries. Bicycling. Risk factors.

• clavicle
• fracture
• rate
• return
• sport
• time

• Epidemiology
• Injury
• Soccer

• Fractures
• Management
• Optimisation
• Outcome
• Sport

• fractures
• outcome
• shaft
• sport
• tibial
• treatment

• ankle
• epidemiology
• fracture
• management
• outcome
• sport

• Epidemiology
• Fracture
• Morbidity
• Return
• Rugby union