Return to Biking following Clavicle Fracture Fixation

Authors: F Taylor, A Watts, M Walton, L Funk

References: Presented at Wrightington Gold Medal Research Day 14 June 2013

Purpose of study: We aimed to investigate whether cyclists and motorcyclists follow surgeons guidelines with regard to return to cycling or motorcycling following operative fixation of clavicle fractures.

Methods: A survey was undertaken of 17 experienced shoulder surgeons (members of the Watanabe Club, UK). Surgeons were asked advised timescales for return to road biking, training, competition and their reasons for these timescales.
These results were then compared with a retrospective review of 17 patients who underwent open reduction internal fixation of the clavicle between 2006 and 2012. This included 7 recreational cyclists, 5 professional cyclists and 5 professional motorcyclists. The average age was 35 years (range, 18¬≠50 years). All fractures were mid-shaft fractures.  Three fixations were performed for non unions in the recreational cyclist group and these patients were excluded from the analysis. 
Primary outcome was the time to return to road biking. 

Results: The survey of Orthopaedic surgeons most commonly gave a recommendation of returning to training at  3-6 weeks and competition at 6-12 weeks (range <3 weeks to >3 months)  The commonest determinant for advising return to road biking was presence of stable clinical and/or radiological union.
The mean follow¬≠up was 43 months after surgery (range, 13 – 71 months). Professional cyclists returned to sport at 3.8 weeks, professional cyclists returned to sport at 7.2 weeks and recreational riders returned at 15 weeks. 
All fractures  clinically and radiologically united.

Conclusion: Cyclists with clavicle fractures can reliably expect to return to their previous level of cycling after surgical reconstruction. Actual time of return to sport does not follow advice commonly prescribed by treating orthopaedic surgeons. Professional cyclists have a rapid return to cycling, followed by professional motorcyclists and then recreational riders. This early return to sport is not shown to have a detrimental effect on the cyclists’ recovery.

Many thanks to the members of the Watanabe Club, UK, who contributed to this study.


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