Sydney University, Australia
Title: Return to Sport post Maxillofacial Fracture in the Professional Athlete: Systematic Review and Australian Practice Guidelines
Umair Ansari is an Australian trained doctor who is currently undertaking a training pathway in maxillofacial surgery. His research history includes publications in hand surgery and orthopaedic fracture management, and has extensive experience working at the registrar level in both orthopaedic surgery and emergency medicine. With a keen interest in sport, this study served to answer the niche question of return to sport post maxillofacial sporting fracture.
Objectives: This systematic review aimed to summarize the current evidence on return to sport of the professional athlete post maxillofacial fracture injury. A secondary aim was to formulate clinical practice guidelines to aid the clinician in recommending a plan for early return to sport. Materials and Methods: A literature search was performed on a total of six databases using subject headings and keywords. Articles relating to the topic areas of maxillofacial fractures, professional athletes, and return to sport were identified. All papers that contained data or expert opinion on time to return to sport post treatment were retrieved. An analysis of study design and appraisal of each paper was then performed, and the clinical recommendations recorded. Findings: A total of 223 papers were identified in our literature search, of which 16 were included (1 prospective and 2 retrospective, 6 case-based, 6 reviews, and 1 survey). Recommendations on return to sport varied between 3 to 12 weeks, depending upon fracture configuration and sport. Many authors (n=9) identified a role for protective facemasks and suggested a graded increase in rehabilitation exercise (n=5) from aerobic to strength training, followed by a return to competitive sport. Conclusion: Based on the available literature, the authors of this paper would advise a conservative approach on return to sport for the professional athlete. The possibility of an early return to sport can be broached via patient discussions referencing the available clinical data. Further research efforts are required to better define the safe parameters for which an early return to sport may be recommended.