Effects of aging on the immune and periosteal response to fracture injury.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest All authors report no conflicts of interest. 4. Br J Sports Med. 1996 Jun;30(2):171-5. doi: 10.1136/bjsm.30.2.171. The footballer's fracture. Cattermole HR(1), Hardy JR, Gregg PJ. Author information: (1)Department of Orthopaedic Surgery, Hospital of St Cross, Rugby, United Kingdom. Erratum in Br J Sports Med 1996 Sep;30(3):273. OBJECTIVE: To describe the typical tibial diaphyseal fracture ("footballer's fracture") and to clarify the circumstances and mechanism of the injury. METHODS: In an attempt to obtain a detailed analysis of the types of injury suffered, and thereby highlight areas for prevention, 100 consecutive adult football players with a tibial diaphyseal fracture were studied prospectively. Details of the circumstances and mechanism of injury were collected using a questionnaire (response rate 85%). Treatments depended on the Gustilo classification, displacement, and axial stability. Long term follow up was performed until clinical healing to define the overall prognosis. RESULTS: 61% of players suffered a fracture of both the tibia and the fibula. Ninety five percent of the tibial fractures were transverse or short oblique and were caused by impact during a tackle. Radiographic evidence of bridging callus was better than a classification of the bony injury for predicting weeks to clinical healing. The delayed union and non-union incidence following this injury is low. One patient suffered symptomatic shortening. One patient suffered symptomatic angulation and two patients with nonunion required bone grafting. CONCLUSIONS: Tibial fracture is an expensive injury. It prevents a young population from being employed and takes up valuable NHS resources. As 85% of players were wearing shin guards, it is likely that improvements in shin guard design could reduce the rate of tibial fracture. DOI: 10.1136/bjsm.30.2.171 PMCID: PMC1332385