Factors associated with time to return to horse racing following a clavicle fracture in jockeys competing in Great Britain: A review and analysis of medical records

Purpose: Competitive horse racing is the second largest sport in Great Britain by spectator attendance, employability, and revenue. It is a lucrative yet hazardous sport, with high injury rates, particularly from falls. Clavicular fractures are one of the most common injuries reported, yet their management, especially regarding return to racing, is under-researched. The purpose of this study was to explore the factors associated with the time to return to competition following a clavicular fracture in jockeys competing in Great Britain. Materials and methods: This review of medical records utilised data from the British Horseracing Authority spanning 2011–2018, inclusive. Data included the jockey’s age, sex, type of licence, race discipline, location of incident, and fracture management. Descriptive statistics and univariable and multivariable generalised linear models were constructed to analyse the impact of these factors on the time to return to racing. Results: Out of 212 records of clavicular fractures, 169 were analysed. The majority (82.8%) of fractures were managed conservatively, with the remainder requiring surgery. The median time to return to racing was 40 days, with an interquartile range of 34 days. Following a clavicular fracture, the results from the univariable and multivariable models indicated that the management approach, whether the fracture is displaced, and the type of race in which the injury occurred have the greatest influence on extending the time to return to racing. In contrast, professional, conditional and amateur licence types, as well as experiencing the injury at a racecourse, were associated with reduced time to return to racing, which may indicate greater risk-taking behaviour. Conclusion: This study offers unique insights into key medical and contextual factors that influence the time to return to racing among jockeys in Great Britain, contributing to tailoring medical management and return to racing protocols to support jockeys’ health and career longevity. Clinicians working within horse racing can use the findings of this study to provide return to racing guidance to trainers, riders and other medical professionals based on the key contextual information reported in this study.