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Conservative care may offer better chance to return to play after lower limb fracture

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Gregory Robertson

COPENHAGEN — Physicians from the United Kingdom have found that soccer players who sustain lower limb fractures are more likely to return to sport if they undergo nonoperative treatment — however, patients who sustain such a fracture after the age of 30 are more likely to stop playing.

Gregory Robertson, FRCS, discussed his team’s findings at the 12th EFORT Congress 2011, here.

“For patients sustaining a lower limb fracture during football, over 80% of them can expect to return to the same level of football or higher by 2-years follow-up,” Robertson said. “We can expect just under half of all patients to be symptomatic 2 years following injuries. However, only a quarter of these patients will have impaired footballing ability.”

Robertson’s team prospectively investigated all soccer-related fractures sustained from 2007 to 2008 in Lothian patients who were treated by the only adult orthopaedic service in Lothian. The 414 patients with 424 fractures included in the study were contacted in August 2010 to determine their return to play.

Thirty-two percent of fractures occurred in the lower limb, with 88% of these injuries returning to football. Eighty-five percent of upper-limb fractures returned to sport.

Thirty-five percent of lower-limb fracture patients were operated upon, Robertson reported.

“For the whole cohort, we found it took a mean time of 25 weeks to return to full-level football,” he said. Patients who underwent surgery had a mean time of 41 weeks to return to full-level play compared with 17 weeks for the nonoperative group.

According to Robertson, 91% of conservatively-treated patients returned to play compared with 84% of surgically-treated patients. Eighty-three percent of patients returned to the same level of play or better, but patients younger than 30 years were 1.4 times more likely to return to play than older patients.

Reference:

• Robertson G, Wood A, Bakker-Dyos J, et al. Football lower limb fractures: Do they return to sport? Paper 730. Presented at the 12th EFORT Congress 2011. June 1-4. Copenhagen.

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