Background:

There is little evidence regarding the mechanisms of pectoralis major (PM) injury and player outcomes in Australian Football League (AFL) players.

Purposes/Hypothesis:

The study aims were to investigate (1) the mechanisms of PM muscle injury in elite AFL players via video analysis and (2) the player profile, method of management, and clinical outcomes of the PM injuries sustained. We hypothesized that the majority of PM tears would occur in outer-range PM positions (hyperextension of the glenohumeral joint).

Study Design:

Case series; Level of evidence, 4.

Methods:

We analyzed video of the precipitating event for traumatic PM injuries during AFL competition or training over a 20-year period (2002-2021). The footage was analyzed by 4 experienced assessors, and the following were evaluated: mechanism of injury, injury variables (arm position, initial contact point, visual awareness, and use of taping), player characteristics (age at the time of injury, hand dominance, and history of injury), injury profile (location and size of tear), method of management (operative vs nonoperative), patient outcomes (time to return to full senior training/match play), and complication rates.

Results:

The mean ± standard deviation age of the players was 26.5 ± 3.1 years (range, 21-32 years). Overall, 22 PM injuries were identified in the AFL injury database for a rate of 1.1 per year; 16 of these injuries had accompanying video footage. We identified 3 mechanisms for PM injury: horizontal hyperextension (62.5%), hyperflexion-abduction (25.0%), and horizontal adduction (sustained tackling; 12.5%). The most common site of the tear was the insertion point of the sternocostal head (91.0%). Twenty players (91.0%) required surgical repair, with 75% undergoing surgery within 1 week (range, 0-26 weeks). The mean return to competition for the surgical repair group was 11.1 weeks (range, 8-15 weeks). The rerupture rate was 5.0% (1 repair; <4 weeks postoperatively in 2004).

Conclusion:

PM tears in elite male AFL players were due to 1 of 3 distinct mechanisms: horizontal hyperextension, hyperflexion-abduction, and horizontal adduction (sustained tackling). Players returned to play on average 11 weeks after injury. Knowledge regarding mechanisms of injury, player profile, and return-to-sport timelines is important for appropriate medical management and provides potential areas to target for prevention of PM injuries.

中文翻译：

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澳大利亚职业足球运动员胸大肌损伤视频分析

背景：

几乎没有证据表明澳大利亚橄榄球联盟 (AFL) 球员的胸大肌 (PM) 损伤机制和球员成绩。

目的/假设：

该研究旨在通过视频分析调查 (1) 精英 AFL 运动员 PM 肌肉损伤的机制，以及 (2) 持续 PM 损伤的球员概况、管理方法和临床结果。我们假设大部分 PM 撕裂将发生在 PM 位置外（盂肱关节过度伸展）。

学习规划：

案例系列；证据水平，4。

方法：

我们分析了 20 年期间（2002-2021 年）AFL 比赛或训练期间创伤性 PM 损伤诱发事件的视频。视频由 4 位经验丰富的评估员分析，并评估以下内容：受伤机制、受伤变量（手臂位置、初始接触点、视觉意识和胶带的使用）、球员特征（受伤时的年龄、手部优势）和损伤史）、损伤概况（撕裂的位置和大小）、治疗方法（手术与非手术）、患者结果（恢复完整高级训练/比赛的时间）和并发症发生率。

结果：

球员的平均 ± 标准差年龄为 26.5 ± 3.1 岁（范围，21-32 岁）。总体而言，在 AFL 伤害数据库中确定了 22 起 PM 伤害，每年 1.1 起；其中 16 人受伤有伴随的录像。我们确定了 PM 损伤的 3 种机制：水平过度伸展（62.5%）、过度屈曲外展（25.0%）和水平内收（持续铲球；12.5%）。最常见的撕裂部位是胸肋骨头的插入点（91.0%）。20 名球员 (91.0%) 需要手术修复，75% 的球员在 1 周内接受手术（范围为 0-26 周）。手术修复组的平均恢复时间为 11.1 周（范围为 8-15 周）。再破裂率为 5.0%（1 次修复；2004 年术后 <4 周）。

结论：

优秀男性 AFL 球员的 PM 撕裂是由于 3 种不同机制中的一种：水平过度伸展、过度屈曲外展和水平内收（持续铲球）。球员在受伤后平均在 11 周内重返赛场。关于受伤机制、球员资料和重返运动时间表的知识对于适当的医疗管理很重要，并为预防 PM 受伤提供了潜在的领域。