JSES - 2026-09-18 - Case Reports; Journal Article
Return to riding after open reduction internal fixation of acute clavicle fractures in professional horse jockeys.
Rowse JC, Faulkner H, Hermans D, Duckworth DG
Topics
Key Takeaway
ORIF of acute clavicle fractures in professional jockeys achieves return to riding at a mean of 7 weeks with a mean 12-month DASH score of 1.
Summary Depth
Choose how much analysis to show on this article page.
Summary
This study evaluated the safety and efficacy of ORIF for acute clavicle fractures in professional horse jockeys using a prospectively maintained database reviewed retrospectively from 2008–2024. Seventy-two jockeys underwent limited-incision plating; mean return to riding was 7 weeks, radiographic union at 10 weeks, and 12-month DASH score of 1. Significant complications were rare: severe numbness in 1.4% and plate irritation in 5.6%.
Key Limitation
Absence of a nonoperative comparator group and lack of fracture classification data (displacement, Robinson type, comminution) prevent determination of which fracture patterns drive the observed outcome variance (range 5–16 weeks to return).
Original Abstract
BACKGROUND
High-velocity, traumatic fracture of the clavicle is one of the most common injuries suffered by professional horse jockeys. Operative fixation represents the mainstay of treatment in this cohort. Despite this, there remains a paucity of evidence to guide post-operative recovery and time to return to riding. Accordingly, the aim of the present study was to establish the safety and efficacy of open reduction internal fixation of acute clavicle fractures in professional horse jockeys.
METHODS
A prospectively maintained database was used to retrospectively identify professional horse jockeys that underwent open reduction internal fixation of an acute clavicle fracture between January 2008 and December 2024. All operations were performed using a limited incision approach to expose, reduce and plate the fracture site. Primary clinical outcomes included the Disabilities of the Arm, Shoulder and Hand (DASH) score, and time to return to riding, full range of motion, and radiographic union. Descriptive statistics were calculated, including means for continuous variables and proportions for categorical variables, and comparative analysis of means was performed using independent samples T-tests.
RESULTS
In the 72 professional horse jockeys that underwent open reduction internal fixation for acute clavicle fracture, the mean time to return to riding was 7 weeks (range 5 - 16), with a mean DASH score of 1 (range 0 - 19) at 12 months post-operatively. Mean time to radiographic union was 10 weeks (range 4 - 32), and full range of motion was achieved on average at 7 weeks (range 2 - 32) post-operatively. Significant complications were rare, with patients reporting severe post-operative numbness or plate irritation in 1.4% and 5.6% of cases, respectively.
CONCLUSIONS
Open reduction internal fixation of acute clavicle fractures in professional horse jockeys is safe and efficacious. Operative management in this patient demographic reveals excellent functional outcomes with infrequent complications, and can facilitate timely return to riding.
LEVEL OF EVIDENCE
Level IV: Case Series, Treatment Study.