Dataset Information

Performance and Return to Sport After Hand, Wrist, and Forearm Fractures in the National Hockey League.

ABSTRACT: Purpose:To examine finger, thumb, hand, wrist, and forearm fractures in the National Hockey League (NHL) and determine: (1) basic demographic data, (2) return to sport (RTS) rates, (3) performance after RTS, and (4) the difference in RTS between players treated operatively versus conservatively. Methods:NHL players with finger, thumb, hand, wrist, and forearm fractures between the 1995-1996 and 2014-2015 seasons were identified through team injury reports and archives on public record. Player demographics, RTS rate, games played per season, and performance score for each player were recorded and compared between the preinjury season and one season following injury. Results:A total of 247 total NHL players with hand, wrist, and forearm fractures were identified, consisting of 30.8% finger, 38.5% hand, 13.8% thumb, 14.6% wrist, and 2.4% forearm fractures. Defenseman comprised the majority of players (40.1%). The overall RTS rate was 98.0%, with no significant difference between players with surgery or between injury location groups. In total, 52 players (21.1%) underwent surgery with no significant correlation of surgery rates based on fracture location. The mean number of missed games was 13.8 ± 9.9, with players sustaining wrist and forearm fractures missing the largest number of games (21.6 ± 17.7and 22.8 ± 7.5 games missed, respectively). There was no significant change in games played or performance scores 1 year after injury for players with any of the fracture types compared with baseline preoperative games played and performance. Conclusions:NHL players have a high RTS rate following hand, wrist, and forearm fractures. Players were able to return to preinjury performance within 1 year, regardless of treatment or type of fracture. Level of Evidence:Level IV, case series.

SUBMITTER: Gotlin MJ

PROVIDER: S-EPMC7588639 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Performance and Return to Sport After Hand, Wrist, and Forearm Fractures in the National Hockey League.

Gotlin Matthew J MJ Minhas Shobhit V SV Buchalter Daniel B DB Feder Oren I OI Alaia Michael J MJ Jazrawi Laith M LM

Arthroscopy, sports medicine, and rehabilitation 20200925 5

<h4>Purpose</h4>To examine finger, thumb, hand, wrist, and forearm fractures in the National Hockey League (NHL) and determine: (1) basic demographic data, (2) return to sport (RTS) rates, (3) performance after RTS, and (4) the difference in RTS between players treated operatively versus conservatively.<h4>Methods</h4>NHL players with finger, thumb, hand, wrist, and forearm fractures between the 1995-1996 and 2014-2015 seasons were identified through team injury reports and archives on public re ...[more]

PMID: 33134987

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Project description:CONTEXT:Postconcussion deficits in neurocognitive performance and postural control may persist at the time of return to sport participation. How these deficits, if present, affect athletic performance is largely unknown, with prior studies showing mixed results. OBJECTIVE:To evaluate postconcussion National Hockey League player performance using advanced hockey metrics over short- (5 games), medium- (10 games), and long-term (remainder of the season) seasonal performance. DESIGN:Retrospective cohort study. PATIENTS OR OTHER PARTICIPANTS:National Hockey League players who sustained a sport-related concussion (SRC; n = 93) and returned during the same season and players (n = 51) who missed time for non-injury-related reasons. MAIN OUTCOME MEASURE(S):Six performance metrics were used: (1) points per 60 minutes, (2) Corsi percentage, (3) personal Fenwick shooting percentage, (4) scoring chances per 60 minutes, (5) penalty difference, and (6) PDO (not an acronym but sometimes referred to as SVSP% [save percentage shooting percentage]). Performance was compared using 2 (group) × 2 (time) repeated-measures analyses of variance for 3 time windows: (1) ±5 games, (2) ±10 games, and (3) the remainder of the season postconcussion. Alpha values were set at a conservative .01 to account for the lack of independence among dependent variables. RESULTS:No significant interactions were present for any of the 6 dependent variables at any of the 3 time windows. Overall, none of the secondary variables differed. CONCLUSIONS:Using advanced, sport-specific metrics, we found that National Hockey League players did not display worse seasonal performance during 3 postinjury time frames after they sustained an SRC. Whereas laboratory studies have identified lingering neurologic deficits after concussion, our results suggest that these deficits, if present, either do not translate to worse athletic performance or were not captured by these 44 metrics. Further, prospective efforts are needed to accurately quantify performance after SRC among professional hockey players.

Project description:Clavicle fractures are common injuries in professional football. Surgical fixation of these injuries may lead to decreased nonunion rates, improved shoulder strength, and decreased residual functional impairment.To determine (1) return-to-sport (RTS) rate in National Football League (NFL) players after clavicle fracture open reduction and internal fixation (ORIF), (2) postoperative career length and games per season, (3) pre- and postoperative performance, and (4) postoperative performance compared with control players matched by position, age, years of experience, and performance.Cohort study; Level of evidence, 3.Publicly available records were used to identify players who underwent surgical treatment of a clavicle fracture while playing in the NFL. Demographic and performance data were collected for each player, and matched controls were identified. Control and case performance scores were calculated using a standardized scoring system. RTS was defined as playing in 1 NFL game after surgery. Comparisons between case and control groups at preoperative and postoperative time points were made using paired-samples Student t tests.Seventeen surgeries (16 players) were analyzed. Fifteen players (94.1%) were able to RTS in the NFL at a mean 211.3 ± 144.7 days postsurgery; 7 (44%) returned within the same season as their injury and subsequent fixation. The overall rate of a player's remaining in the NFL 1 year after surgery was 88.2%. Players who underwent surgery played in a similar number of games per season and had similar career lengths in the NFL as controls (P > .05). There were no significant (P > .05) differences between cases and matched controls presurgery and preindex. There was no difference (P > .05) in postoperative performance scores or games per season compared with preoperative scores or games per season for any position. Quarterbacks (n = 3, P = .049) and running backs (n = 5, P = .039) had significantly worse postoperative performance scores when compared with postindex matched controls.There is a high rate of RTS in the NFL after clavicle fracture ORIF. Players who underwent clavicle fracture ORIF played in a similar number of games per season and had similar career lengths in the NFL as controls. Quarterbacks and running backs had significantly worse postoperative performance scores when compared with postindex matched controls.

Project description:IntroductionThe way strength recovers after reduction of pediatric fractures of the upper extremity has not previously been the specific scope of research. This is remarkable, since strength measurements are often used as an outcome measure in studies on trauma of the upper extremity. The aim of this study was to evaluate how strength recovers after sustainment of fractures of the forearm, wrist or hand treated by closed or open reduction in children and adolescents in the first 6 months after trauma. How much strength is lost at 6 weeks, 3 months and 6 months after trauma, and is this loss significant? Are there differences in the pattern of recovery between children who underwent a different treatment? And finally, which of the following factors are associated with an increase in the ratio between affected grip strength and expected strength: type of fracture, cast immobilization, occurrence of complications, and degree of pain?DesignProspective observational study.ParticipantsChildren and adolescents aged 4-18 years with a reduced fracture of the forearm, wrist or hand.MethodsGrip strength, key grip and three-jaw chuck grip were measured twice in each hand 6 weeks, 3 months and 6 months after trauma. Details on fracture type and location, treatment received, cast immobilization and complications were obtained. Hand-dominance and pain were verbally confirmed.ResultsLoss of strength was more prominent and prolonged the more invasive the treatment, hence most extensive in the group receiving open reduction with internal fixation (ORIF), intermediate in the group receiving closed reduction with percutaneous pinning (CRIF), and least extensive in the group undergoing closed reduction without internal fixation (CR). Besides time passed, gender and age were of significant influence on strength, although there was no difference in pattern of recovery over time between children who received a different treatment. In the period of 6 weeks to 3 months after trauma, female gender, type of fracture sustained and occurrence of an unwanted event were associated with an increased ratio between affected and expected grip strength. For the later phase of recovery, between 3 and 6 months, this was only true for the occurrence of an unwanted event.

Project description:BackgroundOs styloideum describes an accessory carpal ossicle between the trapezoid, the capitate, and the second and third metacarpals. Injuries to this tissue have been described as part of the carpal boss syndrome. While the etiology of os styloideum remains uncertain, it may represent a physiologic response to altered loading forces in the wrist, similar to the development of cam-type deformity in the hips of ice hockey players or the Bennett lesion in the shoulders of baseball pitchers.HypothesisProfessional hockey players will have a higher prevalence of os styloideum compared with the general population.Study designCase series.Level of evidenceLevel 4.MethodsA retrospective review of 16 professional hockey players from 4 different National Hockey League (NHL) teams who underwent unilateral imaging of the wrist was performed. Seventeen wrists were reviewed for the presence of os styloideum.ResultsThirteen of 16 players (81%) had an os styloideum, representing an increased prevalence compared with the general population. Previous clinical and cadaveric studies estimated a general prevalence of up to 19% ( P < 0.001). For the 10 players who had their leading wrist scanned, 9 had an os styloideum (90%). Ten of 11 (91%) players demonstrated a bone marrow edema pattern within the metacarpal and the os styloideum on magnetic resonance imaging. There was no significant association between the presence of an os styloideum and the player's position, leading wrist, or years in the league.ConclusionThere appears to be an increased prevalence of os styloideum among NHL players, and team physicians should consider this finding while formulating a differential diagnosis for dorsal wrist pain.Clinical relevanceThis study identified NHL players as having an increased prevalence of os styloideum compared with the general population. By doing so, these findings represent an opportunity to enhance our understanding of the etiology, clinical significance, and treatment of os styloideum.

Project description:BackgroundConsiderable variability exists in return-to-play rates after anterior cruciate ligament (ACL) injury and reconstruction (ACLR) among National Football League (NFL) players of different positions.Purpose/hypothesisThe purpose of this study was to compare return-to-play and performance levels by position in NFL players after ACLR. It was hypothesized that (1) ACL injuries have significant effects on the careers of NFL players, including return to play and performance, and (2) players of certain positions that involve relatively less pivoting and cutting perform better after ACLR.Study designDescriptive epidemiology study.MethodsAll NFL players who underwent ACLR between 2013 and 2018 were identified using the FantasyData injury database. Player characteristics, snap count, games played, games started, and performance metrics were collected for 3 years before and after injury using the Pro Football Reference database. Performance was measured using an approximate value (AV) algorithm to compare performance across positions and over time. Nonparametric tests were used to compare the pre- and postinjury data and the percentage change in performance between different positions.ResultsOverall, 312 NFL players were included in this study, and 174 (55.8%) returned to play. Of the eligible players, only 28.5% (n = 59/207) remained in the league 3 years postinjury. Within the first 3 years postinjury, players played in fewer games (8.7 vs 13.7; P < .0001), started in fewer games (3.0 vs 8.3; P < .0001), had lower AVs (1.5 vs 4.3; P < .0001), and had decreased snap counts (259.0 vs 619.0; P < .0001) compared with preinjury. Quarterbacks were most likely to return to play (92.9% vs 53.7%; P = .0040) and to return to performance (2% vs 50% decrease in AV; P = .0165) compared with the other positions. Running backs had the largest decrease in AV (90.5%), followed by defensive linemen (76.2%) and linebackers (62.5%).ConclusionThe study findings indicated that NFL players are severely affected by ACL injury, with only 28.5% still active in the league 3 years after the injury. Running backs, defensive linemen, and linebackers performed the worst after injury. Quarterbacks were most likely to return to play and had superior postinjury performance compared with the other positions.

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Dataset Information

Performance and Return to Sport After Hand, Wrist, and Forearm Fractures in the National Hockey League.

Publications

Performance and Return to Sport After Hand, Wrist, and Forearm Fractures in the National Hockey League.

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