High rates of return-to-play and No deterioration in performance following ankle fractures in National Hockey League players.

Abstract

Ankle fractures are common injuries in high-impact sports but have not been extensively studied in professional hockey. Given the high-speed, collision-heavy nature of the National Hockey League (NHL), ankle fractures may significantly affect player performance and team resources. To investigate the incidence, management, and impact of ankle fractures on return-to-play (RTP) and performance metrics among NHL players. A retrospective review of NHL players from 2013 to 2023 identified 30 athletes who sustained ankle fractures. Injury data, treatment intervention (surgical vs. non-surgical), and mechanism of injury were recorded from an online databse. Performance metrics were compared between pre- and post-injury seasons using non-parametric statistical methods. The calculated rate of occurrence was 0.52 ankle fractures per 10,000 athlete exposures. All players returned to NHL play, with a mean time to return of 1.8 ± 1.0 months. There were no significant differences in performance metrics, including goals, assists, points, time on ice, or shooting efficiency, between pre- and post-injury seasons. Surgically treated players had a longer recovery time (2.7 vs. 1.4 months; <i>p</i> = 0.007) but missed a similar number of games compared to non-surgically treated players (16.6 ± 14.5 vs 16.2 ± 12.1 games missed, p = 0.756). Puck impact injuries were more likely to require surgery than contact-related injuries (<i>p</i> = 0.038). No player sustained a refracture. This study found that ankle fractures are a rare injury sustained by NHL players but do not lead to statistically significant deterioration in player performance metrics. All NHL players successfully returned to play at the NHL level at a mean time to RTP of 1.8 months. Taken together, these findings indicate that ankle fractures in NHL players have minimal effect on their ability to return to and maintain pre-injury performance levels.