Return to riding after open reduction internal fixation of acute clavicle fractures in professional horse jockeys.

Return to riding after surgical fixation of clavicle fractures in professional horse jockeys is generally safe and effective, with most athletes regaining full function and resuming riding in about seven weeks.

Background and Purpose

• Clavicle fractures are common in professional horse jockeys due to high-velocity trauma during racing incidents.
• Open reduction internal fixation (ORIF) is a surgical method to realign and stabilize the broken clavicle using plates and screws.
• There is limited evidence guiding recovery timelines and safe return to riding after surgery in this specific athlete group.
• The study aimed to evaluate the safety, effectiveness, and recovery outcomes of ORIF for acute clavicle fractures in professional horse jockeys.

Methods

• A prospectively maintained database was retrospectively reviewed for cases from January 2008 through December 2024.
• The study included 72 professional horse jockeys who underwent ORIF for acute clavicle fractures.
• The surgical technique involved a limited incision to expose the fracture, realigning the bone fragments, and plating the fracture site.
• Primary outcomes measured:
  • Disabilities of the Arm, Shoulder, and Hand (DASH) score to assess functional recovery.
  • Time to return to riding.
  • Time to achieve full range of motion.
  • Radiographic union indicating bone healing.
• Data analysis used descriptive statistics and independent samples T-tests to compare means.

Results

• The average time for jockeys to resume riding was 7 weeks, ranging from 5 to 16 weeks.
• The average DASH score at 12 months post-operation was 1, indicating minimal disability (range 0-19).
• Radiographic evidence of fracture healing occurred on average by 10 weeks, with a range from 4 to 32 weeks.
• Full range of motion was regained at approximately 7 weeks on average, ranging from 2 to 32 weeks.
• Complications were rare:
  • Severe postoperative numbness occurred in only 1.4% of patients.
  • Plate irritation was reported in 5.6% of cases.

Conclusions

• ORIF is a safe and effective treatment for clavicle fractures in professional horse jockeys.
• The surgical intervention leads to excellent functional outcomes and low complication rates.
• This treatment method supports a relatively rapid and safe return to professional riding activities.
• The findings provide important evidence to guide post-operative recovery and return-to-sport timelines in this high-risk athletic population.