Contact is responsible for as much as 82 percent of the injuries sustained in hockey. The incidence of hockey injuries has also been found to increase dramatically with the age of the player. Between ages 11 and 14, the injury rate is about one per 100 hours of playing time. Players ages 18 to 21 sustain injuries at a rate of one per 11 hours of play and professionals sustain injuries at a rate of one per seven hours of play. The greater intensity of play apparently is a significant factor in causing injuries.
Ice Hockey Injuries: How To Maximize Treatment Results
- Volume 15 - Issue 8 - August 2002
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Expert Pointers On Treating Foot And Toe Fractures
Although the foot is protected by a solid boot made of leather and plastic, foot injuries still occur frequently in hockey. Fractures and contusions account for most of the foot injuries. Fractures of the feet are almost invariably the result of impact by the puck or stick.
The most commonly fractured bones are the navicular and the base of the fifth metatarsal (styloid process). The first through fourth metatarsals are fractured much less frequently. These fractures are usually oblique but can appear comminuted or spiral. When these fractures are not displaced, players often “play through the pain.” Treatment for these fractures consists of four to eight weeks of immobilization, depending on the injury. If the fracture is displaced and cannot be closed or reduced, it may be necessary to perform ORIF.
Toe fractures are not very common in hockey due to the hard toe of the skate. However, these fractures do occur occasionally due to direct trauma from a puck or stick. You may see a subungual hematoma with these injuries and the fracture will usually be comminuted. The player will present with pain, edema and ecchymosis of the affected toe.
Treatment of nondisplaced toe fractures consists of immobilization splinting to the neighboring toe with tape, felt or prefabricated splints. With these cases, you can expect a return to action in a matter of days. If the fracture is displaced, depending on severity, you should perform a closed or ORIF. Return to play will then take a couple of weeks, depending on the degree of displacement and the amount of reduction and stabilization you perform on the area.
Dr.Caselli (shown on the right) is Vice-President of the Greater New York Regional Chapter of the American College of Sports Medicine and is a Professor in the Department of Orthopedic Sciences at the New York College of Podiatric Medicine (NYCPM). Ms. Gagne and Mr. Kaplan are both senior students at NYCPM.
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