Robertson GAJ, Sinha A, Hodkinson T, Koç T. Return to sport following toe phalanx fractures: A systematic review. World J Orthop 2023; 14(6): 471-484 [PMID: 37377988 DOI: 10.5312/wjo.v14.i6.471]
Corresponding Author of This Article
Greg A J Robertson, BSc, FRCS (Ed), MBChB, MSc, PhD, Surgeon, Department of Orthopaedic Surgery, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, United Kingdom. greg_robertson@live.co.uk
Research Domain of This Article
Orthopedics
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jun 18, 2023; 14(6): 471-484 Published online Jun 18, 2023. doi: 10.5312/wjo.v14.i6.471
Return to sport following toe phalanx fractures: A systematic review
Greg A J Robertson, Amit Sinha, Thomas Hodkinson, Togay Koç
Greg A J Robertson, Department of Orthopaedic Surgery, Queen Alexandra Hospital, Portsmouth PO6 3LY, United Kingdom
Amit Sinha, Department of Trauma and Orthopaedic Surgery, Wales Deanery, Cardiff CF15 7QQ, United Kingdom
Thomas Hodkinson, Department of Orthopaedic Surgery, Hull University Teaching Hospitals NHS Trust, Hull HU3 2JZ, United Kingdom
Togay Koç, Department of Trauma and Orthopaedic Surgery, Southampton General Hospital, Southampton SO16 6YD, United Kingdom
Author contributions: Robertson GAJ conceived the methodology for the manuscript, performed the literature search and analysis for the study and wrote the manuscript; Sinha A performed the literature search and analysis for the study, and reviewed and edited the manuscript; Hodkinson T advised on the study, and reviewed and edited the manuscript; Koç T advised on the study, and reviewed and edited the manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Greg A J Robertson, BSc, FRCS (Ed), MBChB, MSc, PhD, Surgeon, Department of Orthopaedic Surgery, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, United Kingdom. greg_robertson@live.co.uk
Received: January 15, 2023 Peer-review started: January 15, 2023 First decision: February 21, 2023 Revised: March 19, 2023 Accepted: May 6, 2023 Article in press: May 6, 2023 Published online: June 18, 2023 Processing time: 154 Days and 10 Hours
ARTICLE HIGHLIGHTS
Research background
There is very little evidence available to guide the management of toe phalanx fractures in the athletic population.
Research motivation
This is the first systematic review to assess return to sport following toe phalanx fractures. It provides a comprehensive overview of the available literature, assessing both acute fractures and stress fractures.
Research objectives
To systemically review all studies recording return to sport following toe phalanx fractures (including acute fractures and stress fractures), and to collate information on return rates to sport (RRS) and return times (RTS) to the sport.
Research methods
A systematic search of all relevant scientific databases was performed followed by manual screening of articles according to the eligibility criteria.
Research results
Most toe phalanx fractures were treated conservatively. Surgical management was reserved for displaced or intra-articular acute fractures, as well as symptomatic stress fracture non-unions, and stress fractures with significant underlying deformity. RRS for both acute fractures and stress fractures managed conservatively ranged from 0% to 100%. RRS for both acute fractures and stress fractures managed surgically was 100%. RTS after conservative management ranged from 8.5 d to 6 mo for acute fractures, and 5 wk to 3 mo for stress fractures. RTS after surgical management ranged from 3 to 6 mo for acute fractures, and 10 wk to 4 mo for stress fractures.
Research conclusions
The majority of sport-related toe phalanx fractures (acute and stress) are managed conservatively with overall satisfactory RRS and RTS.
Research perspectives
Currently, the available literature regarding return to sport after toe phalanx fractures is limited, with most studies being low-volume case series. Further research is required to better define the optimal treatment and rehabilitation of sport related toe phalanx fractures.
