Performance and Return to Sport After Forearm Fracture Open Reduction and Internal Fixation in National Football League Players

Abstract

Background: Forearm fractures are one of the most common upper extremity injuries requiring surgery in professional football. Surgical fixation of forearm fractures may speed recovery and decrease games missed in football.

Methods: National Football League (NFL) players who underwent forearm fracture open reduction and internal fixation (ORIF) were identified. Matched controls (position, age, experience, performance) were identified. Control and case performance scores were calculated using a standardized scoring system. Return to sport (RTS) in the NFL was defined as playing in a single NFL game after surgery. Comparisons between case and control groups and preoperative and postoperative time points were made using paired-samples Student t tests.

Results: Thirty-six surgeries were analyzed following ORIF. Thirty-three were able to RTS in the NFL at an average of 152.1 + 129.8 days. Controls had a significantly longer NFL career ( P < .001) and played in significantly more games per season ( P = .026) than players who underwent surgery. There was a significant ( P = .013) decrease in games/season for DBs following surgery. No significant difference was seen in postoperative performance scores compared with preoperative scores among any positions, nor in postoperative and postindex performance scores compared with matched controls.

Conclusion: There is a high rate of RTS in the NFL following forearm fracture ORIF. Following surgery, players' careers were 1 year shorter and played nearly 2 fewer games per season than matched controls. Games per season following surgery was significantly lower among DBs when compared with presurgery. Postoperative performance scores were not significantly different compared with preoperative and when compared with matched controls.

Keywords: NFL upper extremity injury; ORIF; forearm fracture; open reduction internal fixation; sports injuries.

Figure 1.

Flowchart illustrating application of exclusion criteria. Note. ORIF = open reduction and internal fixation; NFL = National Football League.

Figure 2.

Performance scores by position before and after surgery compared with controls pre and postindex. Note. QB = quarterback; RB = running back; TE = tight end; WR = wide receiver; DB = defensive back; LB = linebacker; DL = defensive lineman.