The Epidemiology, Management, and Outcome of Field Hockey‑related Fractures in a Standard Population

Document Type: Original Article

Authors

1 Department of Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, Scotland

2 Department of Orthopaedic, Leeds General Infirmary, Leeds, England, United Kingdom

Abstract

Background: Field hockey is one of the most popular sports in the world, yet little is known about patient outcome following fracture
injuries sustained during this sport. Objectives: The aim of this study is to describe the epidemiology, management, and outcome of
field hockey‑related fractures in a known UK population at all skill levels. Materials and Methods: All fractures sustained during field
hockey from 2007 to 2008 within the adult Lothian population were prospectively recorded and confirmed by an orthopedic surgeon
during treatment at the sole adult orthopedic center in the region. Nonresident individuals were not included in the study. Follow‑up data
were obtained in September 2010 to determine return rates and times to field hockey. Results: Nineteen fractures were recorded over the
study period in 19 patients. Seventeen (89%) of the fractures were recorded in the upper limb, with 15 (79%) recorded in hand. Eighteen
fractures (85%) in 18 patients (95%) were followed up at a mean interval of 31 months (range: 25–37 months; standard deviation [SD]
2.1 months). The mean time for return to field hockey from injury was 10.8 weeks (range: 3–26 weeks; SD 7.1 weeks). For patients with
upper limb injuries, the mean time was 9.2 weeks (range: 3–20 weeks; SD 5.7 weeks), compared to 22 weeks (range: 18–26 weeks; SD
5.7 weeks) for patients with lower limb injuries. Eleven percent of the cohort did not return to field hockey. Seventy‑eight percent of
the cohort returned to field hockey at the same level or higher. Fifty percent had ongoing related problems, yet only 17% had impaired
field hockey ability because of these problems. Fractures with the highest morbidity in not returning to field hockey were as follows:
Metacarpal 14% and finger phalanx 13%. Conclusions: The significant majority of field hockey‑related fractures are sustained in the
upper limb, notably the hand. Around ninety percent of patients sustaining a fracture during field hockey will return to this sport at a
similar level. While half of these will have persisting symptoms 2 years postinjury, only one‑third of symptomatic patients will have
impaired field hockey ability because of this.

Keywords


1. International Hockey Federation. International Hockey Federation:
Hockey Basics. Available from: http://www.fih.ch/hockey‑basics/
history/2017. [Last accessed on 2017 Jan 07].
2. SportsScotland. Sports Participation in Scotland 2008: Research
Digest no. 110; 2008. Available from: https://www.sportscotland.org.
uk/documents/participation/sports_participation_in_scotland_2008_
research_digest_july_2010.pdf. [Last accessed on 2017 Jan 07].
3. SportEngland. Active People Survey 10 October, 2015 – September,
2016: Once a Week Participation in Funded Sports amongst People Aged
16 Years and Over; 2016. Available from: https://www.sportengland.
org/research/who‑plays‑sport/by‑sport/. [Last accessed on 2017 Jan 07].
4. Murtaugh K. Injury patterns among female field hockey players. Med
Sci Sports Exerc 2001;33:201‑7.
5. Dick R, Hootman JM, Agel J, Vela L, Marshall SW, Messina R, et al.
Descriptive epidemiology of collegiate women’s field hockey injuries:
National Collegiate Athletic Association Injury Surveillance System,
1988‑1989 through 2002‑2003. J Athl Train 2007;42:211‑20.
6. Bowers AL, Baldwin KD, Sennett BJ. Athletic hand injuries
in intercollegiate field hockey players. Med Sci Sports Exerc
2008;40:2022‑6.
7. Aitken S, Court‑Brown CM. The epidemiology of sports‑related
fractures of the hand. Injury 2008;39:1377‑83.
8. Aitken SA, Watson BS, Wood AM, Court‑Brown CM. Sports‑related
fractures in South East Scotland: An analysis of 990 fractures. J Orthop
Surg (Hong Kong) 2014;22:313‑7.
9. Court‑Brown CM, Wood AM, Aitken S. The epidemiology of acute
sports‑related fractures in adults. Injury 2008;39:1365‑72.
10. O’Neill BJ, Ryan K, Burke NG, Moroney PJ. Bilateral distal tibial
stress fractures in a healthy field‑hockey goalkeeper. BMJ Case Rep
2014;2014:pii: bcr2014205353.
11. Slipman CW, Gilchrist RV, Isaac Z, Lenrow DA, Chou LH. Sacral
stress fracture in a female field hockey player. Am J Phys Med Rehabil
2003;82:893‑6.
12. Metz JP. Bilateral first metatarsal stress fractures in a field hockey
player. Phys Sportsmed 2005;33:50‑8.
13. Murtaugh K. Field hockey injuries. Curr Sports Med Rep 2009;8:267‑72.
14. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one
thousand and twenty‑five open fractures of long bones: Retrospective
and prospective analyses. J Bone Joint Surg Am 1976;58:453‑8.
15. Robertson GA, Wood AM, Bakker‑Dyos J, Aitken SA, Keenan AC,
Court‑Brown CM, et al. The epidemiology, morbidity, and outcome
of soccer‑related fractures in a standard population. Am J Sports Med
2012;40:1851‑7.
16. Robertson GA, Wood AM, Heil K, Aitken SA, Court‑Brown CM. The
epidemiology, morbidity and outcome of fractures in rugby union from
a standard population. Injury 2014;45:677‑83.
17. Hon WH, Kock SH. Sports related fractures: A review of 113 cases.
J Orthop Surg (Hong Kong) 2001;9:35‑8.