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High return-to-sport rate seen after ORIF for forearm fractures in NFL players
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Investigators found a high rate of return to sport among National Football League players who had open reduction and internal fixation for treatment of forearm fractures.
“Forearm fractures can be career-threatening injuries for professional athletes,” Joshua D. Harris, MD, told Healio.com/Orthopedics. “However, excellent outcomes and return to sport can be achieved following timely and appropriate surgical management of these injuries.”
Harris and colleagues identified 36 open reduction and internal fixation (ORIF) surgeries for forearm fractures among 34 National Football League (NFL) players. The group was matched for position, age, performance and experience to a control group of 33 NFL players who did not undergo surgery for their fractures. A standardized scoring system was used to calculate performance scores. Paired-samples student t tests were used to compare outcomes for the groups.
Results showed 33 NFL players who underwent ORIF returned to sport at an average of 152.1 days. Investigators noted controls had a significantly longer career and played more games per season compared with the ORIF group.
Following surgery, defensive backs had a significant decrease in game/season. Performance scores were not significantly different compared with preoperative scores among any player positions. There was no significant difference in postoperative and postindex performance scores vs. the matched controls. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.
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Gregory L. Cvetanovich, MD
Sochacki and colleagues used publicly available internet sources to identify NFL players who underwent forearm fracture open reduction and internal fixation (ORIF) and sought to determine whether these players were able to return to sport (RTS) in the NFL and how their performance was impacted by the surgery. They found 36 NFL players who underwent this procedure from 1987 to 2016, of whom 33 (92%) returned to NFL competition at an average of 152 days postoperatively. The injury was most common in defensive backs (21 of 36, 58%). Postoperative performance after forearm fracture ORIF did not differ from pre-injury performance nor from performance of matched controls. Nevertheless, players’ careers were an average of 1-year shorter compared to matched controls.
This study confirms the high RTS rate for forearm fracture ORIF from a prior report by Mai and colleagues, but extends these findings to evaluate not just RTS, but also more detailed analysis of player performance. Limitations of this study include potential selection and reporting biases related to the strategy of identifying these injuries via publicly available internet sources. In addition, this methodology makes it impossible to determine many parameters of interest to the orthopedic surgeon including specific fracture characteristics (eg, one vs. both bone, fracture pattern, comminution, open injury, associated neurovascular injury, dislocation), surgical technique and approach, patient-reported outcome measures, postoperative radiographic outcomes and complications.
The take-home message of the study is that forearm fracture ORIF is an uncommon procedure in NFL players but that players have high rates of RTS and no change in their performance compared to before injury, but a 1-year shorter career compared to other players.
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