Return to play after shoulder instability in National Football League athletes.

HYPOTHESIS: We hypothesized that National Football League (NFL) players sustaining a shoulder destabilizing injury could return to play (RTP) successfully at a high rate regardless of treatment type. METHODS: We identified and evaluated 83 NFL players who sustained an in-season shoulder instability event while playing in the NFL. NFL RTP, incidence of surgery, time to RTP, recurrent instability events, seasons/games played after the injury, and demographic data were collected. Overall RTP was determined, and players who did and did not undergo operative repair were compared. RESULTS: Ninety-two percent of NFL players returned to NFL regular season play at a median of 0.0 weeks in those sustaining a shoulder subluxation and 3.0 weeks in those sustaining a dislocation who did not undergo surgical repair (P = .029). Players who underwent operative repair returned to play at a median of 39.3 weeks. Forty-seven percent of players had a recurrent instability event. For players who were able to RTP, those who underwent surgical repair (31%) had a lower recurrence rate (26% vs. 55%, P = .021) and longer interval between a recurrent instability event after RTP (14.7 vs. 2.5 weeks, P = .050). CONCLUSION: There is a high rate of RTP after shoulder instability events in NFL players. Players who sustain shoulder subluxations RTP faster but are more likely to experience recurrent instability than those with shoulder dislocations. Surgical stabilization of the shoulder after an instability event decreases the chances of a second instability event and affords a player a greater interval between the initial injury and a recurrent event.

Proximal Tibiofibular Dislocation Repaired with Syndesmotic Suture Buttons: A Case Report.

INTRODUCTION: Dislocations of the proximal tibiofibular joint (PTFJ) are a relatively rare orthopedic injury. They are often repaired with open reduction internal fixation utilizing a transfixation screw. Limited data are available concerning alternative repair methods. CASE REPORT: This report details a 46-year-old male who presented with an open Type IIIA comminuted mid-shaft tibia and segmental fibula fractures after being struck by a car traveling 70mph. Computed tomography confirmed comminuted and displaced tibia and fibula fractures with PTFJ dislocation as well as air tracking through the anterior compartment of the leg communicating with the knee joint. He underwent open reduction internal fixation with intramedullary nailing of his tibial shaft fracture and PTFJ syndesmosis repair with two suture buttons. X-ray at post-operative follow-up 2 years later showed complete healing without evidence of failure or hardware loosening. CONCLUSION: This case illustrates a patient treated with suture buttons, which provides an alternative option in treating PTFJ dislocations with a reported decreased likelihood of hardware removal and faster return to work.