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High return-to-sport rates seen in NFL players treated nonoperatively, operatively for clavicle fractures
Results from two recently published studies found a high return-to-sport rate in National Football League players who underwent either nonoperative treatment or operative treatment of clavicle fractures.
“Clavicle fractures are so common in NFL athletes because of tackling and the contact that occurs,” Peter J. Millett, MD, MSc, told Healio.com/Orthopedics. “They are most common in cases where the athlete is tackled and the shoulder is then driven into the ground, as recently occurred with NFL quarterback Aaron Rodgers.”
Nonoperative treatment of clavicle fractures
In a study published in Orthopedics, investigators evaluated 30 NFL players who were nonoperatively treated for clavicle fractures. Researchers found athletes returned to sport at a high rate, with 96.9% returning to sport at a mean of 244.6 days and 27.6% returned within the same season as their injury. After treatment, wide receivers played fewer games throughout the season.
Despite the high return-to-sport rate with nonoperative treatment, Millett is an advocate for surgical treatment of clavicle fractures in athletes.
“Surgical treatment is the preferred strategy for displaced fractures, high comminuted fractures and for fractures that are shortened 15 mm or more, he said. “We also discuss operative treatment with high-level athletes and laborers, as operative treatment frequently allows these patients to get back to sports or work much more quickly. In certain instances, I have had some athletes back to competition in as little as 2 weeks.”
Operative treatment of clavicle fractures
Researchers of a study published in the Orthopaedic Journal of Sports Medicine evaluated return to sport in 16 NFL players with clavicle fractures who underwent open reduction and internal fixation (ORIF). They found 94.1% of players returned to sport at a mean of 211.3 days after ORIF and 44% of players returned within the same season as the injury and fixation. After 1 year postoperatively, 88.2% of players remained in the NFL.
“The offensive skill positions represented the largest proportion of players who underwent clavicle fracture ORIF, with 13 (81.3%),” the researchers wrote. “We hypothesize that the increased incidence of clavicle fractures within these position groups is likely due to getting tackled and driven into the ground onto the shoulder. On the contrary, defensive players are typically doing the tackling and are better able to control their bodies to avoid direct impact on the shoulder when they reach the ground.”
Millett said that in his own experience, athletes have a faster and more predictable return to play after operative treatment with ORIF.
Millett said, “[Surgical] treatment using modern techniques with open reduction and internal fixation is resulting in faster recoveries and more predictable outcomes for our athletes, weekend warriors and everyday patients.” – by Monica Jaramillo
References:
Jack RA 2nd, et al. Orthopedics. 2017;doi:10.3928/01477447-20170719-03.
Jack RA 2nd, et al. Orthop J Sports Med. 2017;doi:10.1177/2325967117720677.
Disclosures: Millett reports he receives intellectual property royalties from, is a paid consultant for and receives research support from Arthrex Inc.; has stock or stock options in Game Ready and VuMedi; receives IP royalties from Medbridge; and receives research support from Ossur, Siemens and Smith & Nephew. Please see the full studies for a list of all other author’s relevant financial disclosures.