Return to sport following toe phalanx fractures: A systematic review

ARTICLE HIGHLIGHTS

Research background

There is very little evidence available to guide the management of toe phalanx fractures in the athletic population.

Research motivation

This is the first systematic review to assess return to sport following toe phalanx fractures. It provides a comprehensive overview of the available literature, assessing both acute fractures and stress fractures.

Research objectives

To systemically review all studies recording return to sport following toe phalanx fractures (including acute fractures and stress fractures), and to collate information on return rates to sport (RRS) and return times (RTS) to the sport.

Research methods

A systematic search of all relevant scientific databases was performed followed by manual screening of articles according to the eligibility criteria.

Research results

Most toe phalanx fractures were treated conservatively. Surgical management was reserved for displaced or intra-articular acute fractures, as well as symptomatic stress fracture non-unions, and stress fractures with significant underlying deformity. RRS for both acute fractures and stress fractures managed conservatively ranged from 0% to 100%. RRS for both acute fractures and stress fractures managed surgically was 100%. RTS after conservative management ranged from 8.5 d to 6 mo for acute fractures, and 5 wk to 3 mo for stress fractures. RTS after surgical management ranged from 3 to 6 mo for acute fractures, and 10 wk to 4 mo for stress fractures.

Research conclusions

The majority of sport-related toe phalanx fractures (acute and stress) are managed conservatively with overall satisfactory RRS and RTS.

Research perspectives

Currently, the available literature regarding return to sport after toe phalanx fractures is limited, with most studies being low-volume case series. Further research is required to better define the optimal treatment and rehabilitation of sport related toe phalanx fractures.