Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jun 18, 2023; 14(6): 471-484
Published online Jun 18, 2023. doi: 10.5312/wjo.v14.i6.471
Return to sport following toe phalanx fractures: A systematic review
Greg A J Robertson, Amit Sinha, Thomas Hodkinson, Togay Koç
Greg A J Robertson, Department of Orthopaedic Surgery, Queen Alexandra Hospital, Portsmouth PO6 3LY, United Kingdom
Amit Sinha, Department of Trauma and Orthopaedic Surgery, Wales Deanery, Cardiff CF15 7QQ, United Kingdom
Thomas Hodkinson, Department of Orthopaedic Surgery, Hull University Teaching Hospitals NHS Trust, Hull HU3 2JZ, United Kingdom
Togay Koç, Department of Trauma and Orthopaedic Surgery, Southampton General Hospital, Southampton SO16 6YD, United Kingdom
Author contributions: Robertson GAJ conceived the methodology for the manuscript, performed the literature search and analysis for the study and wrote the manuscript; Sinha A performed the literature search and analysis for the study, and reviewed and edited the manuscript; Hodkinson T advised on the study, and reviewed and edited the manuscript; Koç T advised on the study, and reviewed and edited the manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Greg A J Robertson, BSc, FRCS (Ed), MBChB, MSc, PhD, Surgeon, Department of Orthopaedic Surgery, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, United Kingdom. greg_robertson@live.co.uk
Received: January 15, 2023
Peer-review started: January 15, 2023
First decision: February 21, 2023
Revised: March 19, 2023
Accepted: May 6, 2023
Article in press: May 6, 2023
Published online: June 18, 2023
Core Tip

Core Tip: We performed a systematic review, assessing studies that recorded return rates (RRS) and return times (RTS) to sports following acute and stress fractures of the toe phalanges. Thirteen studies were included. Seven studies reported on acute fractures (n = 156); six studies on stress fractures (n = 26). For acute fractures, 63 underwent primary conservative management (PCM), 6 primary surgical management (PSM), and 1 sary surgical management (SSM). For stress fractures, 23 underwent PCM, 3 PSM, and 6 SSM. For acute fractures, PCM conferred acceptable RRS and RTS. PSM was indicated for displaced intra-articular proximal phalanx fractures. For stress fractures, PCM, when successful, conferred acceptable RTS. Significant delays to diagnosis or associated deformity often necessitated the conversion to SSM: this was invariably successful at returning athletes to sport.