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.

Fig 1

Change in games played the season following injury. This figure depicts the change in games played for different fracture locations. Data points below the zero line demonstrate a reduction in games played the season after the injury, whereas data points above the zero line demonstrate an increase in games played the season after injury. None of the data points were statistically significant.

Fig 2

Change in performance score the season following injury. This figure depicts the change in performance for different fracture locations. Data points below the zero line demonstrate a reduction in performance the season after the injury, whereas data points above the zero line demonstrate an increase in performance the season after injury. None of the data points were statistically significant.