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. 2020 Mar 26:22:100-103.
doi: 10.1016/j.jor.2020.03.039. eCollection 2020 Nov-Dec.

Hand fractures and return to play in elite Australian cricketers

Kendall Brooks  1 , John W Orchard  2 , Anna E Saw  2 , Alex Kountouris  2   3
Affiliations

Hand fractures and return to play in elite Australian cricketers

Kendall Brooks et al. J Orthop. .

Erratum in

Abstract

Introduction: Hand fractures are one of the most common injuries sustained whilst playing cricket. Further research is required to inform future clinical management and risk-reduction strategies.

Methods: This retrospective cohort study reviewed all cases of hand fractures in elite Australian cricket players over a three-year period. Data included specific activity when injury occurred, location of injury, management (non-surgical or surgical) and days to return to play.

Results: Seventy (17%, 95% CI 14-21 of players; 43 male, 27 female) players sustained 90 hand fractures. Seventy-three (81%, 95% CI 72-89) fractures occurred whilst fielding the ball. Eighty-four (93%, 95% CI 86-97) fractures occurred to the 'exterior' bones of the hand: distal phalanx, middle phalanx, first and fifth rays. Thirteen (14%, 95% CI 9-23) fractures were managed with surgical internal fixation, of which 11 were to the phalanges, most commonly at the proximal phalanx (n = 5, 36% of all proximal phalanx fractures) or fifth ray middle and proximal phalanges (n = 5, 42% of all fifth ray phalangeal fractures). Fractures requiring surgical management typically had longer time injured (median 33 days, IQR 27-41) than fractures managed non-surgically (median 6 days, IQR 0-21) (p = 0.001). Total time to return to full unrestricted play was similar between surgical (49 days, IQR 45-52) and non-surgical (32 days, IQR 15-45) management (p = 0.197).

Conclusions: Hand fractures sustained by elite male and female Australian cricket players were found to display a pattern of occurring to the 'exterior' bones of the hand. The results of this study may inform clinical decision making with respect to non-surgical or surgical management and anticipated return to play times. Further effort is needed to address risk reduction strategies including gloves and skill proficiency.

Keywords: Carpal; Cricket; Finger; Gloves; Injury; Metacarpal; Phalange; Protective equipment; Sport; Surgery; Thumb.

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Figures

Fig. 1
Fig. 1
Number of fractures by bone.
Fig. 2
Fig. 2
Illustration of the ‘exterior’ bones of the hand.
Fig. 3
Fig. 3
Days injured (unable to participate in any activity) by bone and management. MC = metacarpal, PP = proximal phalanx, MP = middle phalanx, DP = distal phalanx.
Fig. 4
Fig. 4
Days to return to full unrestricted activity by bone and management. MC = metacarpal, PP = proximal phalanx, MP = middle phalanx, DP = distal phalanx.
Fig. 5
Fig. 5
Gloves used for fielding drills in training. Note ‘exterior’ bones of the hand are largely unprotected.
See this image and copyright information in PMC

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