Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-40074

Early Return to Play After Minimally Invasive Treatment of Metacarpal Fractures in Elite Football Players

Yener Ince¹, Onur Çetin², Arýn Celayir³, Göker Utku Deðer⁴, Tolgahan Korkmaz^5
1Liv Hospital, Besiktas, Turkey, Department of Orthopaedics and Traumatology
²Istanbul Medipol University, Istanbul, Turkey, Department of Orthopaedics and Traumatology
³Istanbul University – Cerrahpasa, Cerrahpasa Faculty of Medicine, Turkey, Department of Orthopaedics and Traumatology
⁴Beykoz State hospital, Turkey, Department of Orthopaedics and Traumatology
⁵Basaksehir Cam and Sakura City Hospital, Turkey, Department of Orthopaedics and Traumatology

Purpose:
To evaluate the clinical outcomes of closed reduction and crossed retrograde intramedullary Kirschner wire (K-wire) fixation in professional football players with metacarpal fractures, specifically focusing on return to play and complication rates.
Methods:
A total of 27 elite professional football athletes with metacarpal fractures were treated using closed reduction and crossed retrograde K-wire fixation. All surgeries were performed by the same orthopedic surgeon. Postoperative rehabilitation included a standardized protocol and individualized braces designed by a single hand therapist. Clinical and functional outcomes were assessed using range of motion (ROM), grip strength, Visual Analog Scale (VAS) for pain, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, time to return to training and competition, and radiographic healing.
Results:
The mean age of the cohort was 24 years. The fifth metacarpal was the most commonly affected site, and falling onto the pitch was the predominant injury mechanism. Mean return to training was 3.16 weeks, to competition 4.12 weeks, and to radiographic union 4.88 weeks. Mean DASH scores improved from 67.5 to 12.8, VAS from 5.78 to 0.75, MCP joint ROM from 66.75° to 89.25°, and grip strength from 44.87% to 95.55%.
Conclusions:
Closed reduction and crossed retrograde K-wire fixation with personalized postoperative care appears to be a safe, reliable, and minimally invasive method in elite football athletes, enabling early return to play with excellent functional outcomes.
Type of Study/Level of Evidence:
Therapeutic, Level IV

Keywords: Metacarpal fracture, K-wire fixation, professional football players, early return to play, functional outcomes

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Elit Futbolcularda Metakarp Kýrýklarýnýn Minimal Ýnvaziv Tedavisi Sonrasý Erken Spora Dönüþ

Yener Ince¹, Onur Çetin², Arýn Celayir³, Göker Utku Deðer⁴, Tolgahan Korkmaz^5
1Liv Hospital, Besiktas, Turkey, Department of Orthopaedics and Traumatology
²Istanbul Medipol University, Istanbul, Turkey, Department of Orthopaedics and Traumatology
³Istanbul University – Cerrahpasa, Cerrahpasa Faculty of Medicine, Turkey, Department of Orthopaedics and Traumatology
⁴Beykoz State hospital, Turkey, Department of Orthopaedics and Traumatology
⁵Basaksehir Cam and Sakura City Hospital, Turkey, Department of Orthopaedics and Traumatology

Amaç:
Metakarp kýrýðý bulunan profesyonel futbolcularda kapalý redüksiyon ve çapraz retrograd intramedüller Kirschner teli (K-teli) tespiti yönteminin klinik sonuçlarýný deðerlendirmek; özellikle spora dönüþ süresi ve komplikasyon oranlarýna odaklanmak.

Yöntemler:
Metakarp kýrýðý olan toplam 27 elit profesyonel futbolcu, kapalý redüksiyon ve çapraz retrograd K-teli tespiti yöntemiyle tedavi edildi. Tüm cerrahiler ayný ortopedi cerrahý tarafýndan gerçekleþtirildi. Ameliyat sonrasý rehabilitasyon süreci, standart bir protokol ve tek bir el terapisti tarafýndan tasarlanan kiþiye özel atelleri içeriyordu. Klinik ve fonksiyonel sonuçlar; eklem hareket açýklýðý (ROM), kavrama kuvveti, Aðrý için Görsel Analog Skala (VAS), Kol, Omuz ve El Engellilik Anketi (DASH) skorlarý, antrenmana ve müsabakaya dönüþ süresi ile radyografik kaynama açýsýndan deðerlendirildi.

Bulgular:
Çalýþmaya katýlan grubun ortalama yaþý 24’tü. En sýk etkilenen bölge beþinci metakarptý ve saha üzerinde düþme en yaygýn yaralanma mekanizmasýydý. Antrenmana ortalama dönüþ süresi 3.16 hafta, müsabakaya dönüþ 4.12 hafta ve radyografik kaynama 4.88 hafta olarak belirlendi. Ortalama DASH skoru 67.5’ten 12.8’e, VAS skoru 5.78’den 0.75’e, MCP eklem hareket açýklýðý 66.75°’den 89.25°’ye ve kavrama kuvveti %44.87’den %95.55’e yükseldi.

Sonuç:
Kiþiselleþtirilmiþ ameliyat sonrasý bakým ile uygulanan kapalý redüksiyon ve çapraz retrograd K-teli tespiti, elit futbolcularda güvenli, etkili ve minimal invaziv bir yöntem olup, mükemmel fonksiyonel sonuçlarla erken spora dönüþü saðlamaktadýr.

Çalýþma Türü / Kanýt Düzeyi:
Düzey IV

Anahtar Kelimeler: Metakarp kýrýðý, K-teli tespiti, profesyonel futbolcular, erken spora dönüþ, fonksiyonel sonuçlar

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