Splenic Lacerations and Return to Play

BACKGROUND Several sports medicine reviews have highlighted a 3- to 6-month time frame for return to play after splenic lacerations. These reviews are based on several well-defined grading scales for splenic injury based on computed tomography (CT). None of the articles suggest that serial CT scanning is necessary for follow-up; some even indicate that it has no role in the management of these injuries. HYPOTHESIS With proper follow-up and possibly the use of serial CT scanning or other imaging modalities, it may be possible for athletes to safely return to play sooner than what current guidelines recommend. STUDY DESIGN The authors present 2 cases of professional hockey players who both suffered grade III splenic lacerations while playing. METHODS Both players were treated conservatively and monitored with serial CT scanning until radiographic and clinical findings suggested complete healing. RESULTS Both players were able to return to full-contact professional hockey within 2 months after suffering grade III splenic lacerations. Neither athlete suffered any complications after his return. CONCLUSIONS With CT scanning, 2 athletes were able to return to play earlier (2 months) than previously recommended (3-6 months) without compromising their safety. CLINICAL RELEVANCE Additional cases must be examined before outlining more definitive recommendations regarding splenic lacerations in sports, but it is possible that elite athletes may return to play sooner than what the current literature recommends.