Background: Fractures of the metacarpals and phalanges account for more than half of all upper extremity fractures sustained by competitive athletes. Purpose: To determine which management strategy is best for expediting return to preinjury levels of competition in adult athletes with metacarpal and/or phalangeal fractures. Study Design: Systematic review; Level of evidence, 4. Methods: A methodology compliant with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used. A custom search strategy was designed and applied to MEDLINE and In-Process, Embase, EMCARE, and CINAHL. Results: Overall, 3135 records were identified, of which 8 met full inclusion criteria. All patients returned to preinjury levels of competition, at a mean of 30.6 days for phalangeal fractures and 21.9 days for metacarpal fractures. Meta-analysis demonstrated delayed return-to-sport time for operatively managed metacarpal fractures as compared with nonoperatively managed ones (28.5 vs 22.0 days). All studies were of fair or poor quality, and none were randomized. Conclusion: Optimal management strategies for athletes with metacarpal and phalangeal fractures remain equivocal. Injury, treatment, and sport-specific factors may confound results and preclude accurate estimation of optimal treatment strategies at present.
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机译：背景：髓质和骨折的骨折占所有上肢骨折的一半以上，竞争运动员持续了一半。目的：确定哪种管理策略最适合加速恢复成年运动员患者的竞争对手和/或指骨骨折。研究设计：系统评价;使用证据水平，4.方法：使用符合Prisma的方法（用于系统评价和Meta-Analyzes的首选报告项目）。设计并应用于Medline和In-Process，Embase，Emcare和Cinahl的自定义搜索策略。结果：总体而言，确定了3135条记录，其中8符合全纳入标准。所有患者均返回前肢额竞争水平，平均对虾骨折和21.9天的术骨折。荟萃分析表明，与非手术管理的骨折骨折的延迟返回运动时间（28.5 Vs 22.0天）。所有研究都具有公平或差的质量，而且没有随机化。结论：具有梅曲术和骨折骨折的运动员的最佳管理策略仍然是难以置信的。伤害，治疗和体育特定因素可能会困扰结果，并妨碍了目前最佳治疗策略的准确估算。
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