title: Fracture epidemiology in male elite football players from 2001 to 2013: 'How long will this fracture keep me out?'.
abstract: BACKGROUND
  Determining fracture risk and rehabilitation periods after specific fractures in professional football is essential for team planning.
  
  
  OBJECTIVE
  To identify fracture epidemiology and absences after different types of fractures in male professional football players.
  
  
  METHODS
  2439 players from 41 professional male teams in 10 countries were followed prospectively from 2001 to 2013. Team medical staff registered fractures, absences after fractures and player exposure.
  
  
  RESULTS
  364 fractures were recorded, with an incidence of 0.27/1000 h of exposure (95% CI 0.25 to 0.30). The incidence of traumatic fractures was 0.25 (0.22 to 0.27) and that of stress fractures was 0.03 (0.02 to 0.04). 45% of traumatic fractures and 86% of stress fractures affected the lower extremities. Absence after a fracture was 32 days (1-278) (median (range)), compared to that after a traumatic fracture of 30 days (1-278) and a stress fracture of 65 days (6-168) (p<0.001). Annual fracture incidence was stable during the study period (R(2)=0.051, b=-0.011 (95% CI -0.043 to 0.021)). Young players had a relative risk of 10.9 (3.3 to 35.6) of sustaining stress fractures compared to old players (p<0.01). The fracture incidence did not differ between individuals in different playing positions (p=0.10).
  
  
  CONCLUSIONS
  A male professional football team can expect 1 to 2 fractures per season. There are more traumatic fractures than stress fractures; while most fractures affect the lower extremities, stress fractures yield longer absences than traumatic fractures and young players have more stress fractures than old players. There is no difference in risk among players at different playing positions.
authors.affiliation: Department of Clinical Sciences and Orthopedic Surgery, Skåne University Hospital, Lund University Malmö, Malmö, Skåne, Sweden Football Research Group, Linköping University, Linköping, Sweden.
authors.forename: David
authors.initials: D
authors.lastname: Larsson
authors.affiliation: Football Research Group, Linköping University, Linköping, Sweden Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Ekstrand
authors.affiliation: Department of Clinical Sciences and Orthopedic Surgery, Skåne University Hospital, Lund University Malmö, Malmö, Skåne, Sweden.
authors.forename: Magnus K
authors.initials: MK
authors.lastname: Karlsson
mesh_terms: D000041:Absenteeism; D000328:Adult; D017677:Age Distribution; D001265:Athletic Injuries / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation; D005060:Europe / Q000453:epidemiology; D050723:Fractures, Bone / Q000453:epidemiology* / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D011446:Prospective Studies; D020127:Recovery of Function; D000068958:Return to Sport / Q000502:physiology; D012916:Soccer / Q000293:injuries*; D013997:Time Factors; D055815:Young Adult
keywords: Epidemiology; Injury; Soccer