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<p>Transverse process fractures (TPFs) are typically considered minor stable spinal injuries. However, in professional athletes, these fractures can significantly impact function, training and return-to-play decisions. This narrative review examines the anatomy of transverse processes, mechanisms of injury, clinical presentation, imaging modalities, management strategies, rehabilitation principles and return-to-play considerations. A comprehensive review of the literature was conducted, incorporating case studies, sports medicine reports and trauma data to provide an evidence-based approach to TPF diagnosis and management in professional athletes. TPFs in athletes typically result from high-energy direct trauma, excessive rotational forces or muscular avulsion. While inherently stable, they may be associated with concomitant injuries, necessitating a thorough clinical and radiologic evaluation. Despite emerging imaging techniques (e.g. magnetic resonance imaging [MRI] three-dimensional [3D] T1 volumetric interpolated breath-hold examination [VIBE]), computed tomography (CT) imaging remains the gold standard for diagnosis, with MRI useful for detecting soft tissue pathology. Treatment is predominantly non-operative, focusing on multimodal pain control, early mobilization and structured rehabilitation to restore spinal function while preventing complications. Return-to-play is individualized, with most athletes resuming full activity within 3–6&#xa0;weeks for isolated TPFs, though multi-level fractures or associated injuries may prolong recovery. TPFs require careful assessment and management to ensure optimal recovery and a safe return-to-play. A multidisciplinary approach involving orthopaedic surgeons, musculoskeletal radiologists, sports physicians, physiotherapists, sport scientists and coaching staff is essential to balance expedient recovery without long-term sequelae. Understanding sport-specific demands and implementing tailored rehabilitation protocols can allow athletes to make a complete recovery with minimal risk of recurrence.</p>

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Transverse Process Fractures in Athletes: Mechanisms, Management and Return-to-Play Considerations

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月15日

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  • Arnav Barve,
  • Jake M. McDonnell,
  • Conor McCartney,
  • Aubrie Sowa,
  • Danny Miller,
  • Sean Carmody,
  • Stacey Darwish,
  • Joseph S. Butler

摘要

Transverse process fractures (TPFs) are typically considered minor stable spinal injuries. However, in professional athletes, these fractures can significantly impact function, training and return-to-play decisions. This narrative review examines the anatomy of transverse processes, mechanisms of injury, clinical presentation, imaging modalities, management strategies, rehabilitation principles and return-to-play considerations. A comprehensive review of the literature was conducted, incorporating case studies, sports medicine reports and trauma data to provide an evidence-based approach to TPF diagnosis and management in professional athletes. TPFs in athletes typically result from high-energy direct trauma, excessive rotational forces or muscular avulsion. While inherently stable, they may be associated with concomitant injuries, necessitating a thorough clinical and radiologic evaluation. Despite emerging imaging techniques (e.g. magnetic resonance imaging [MRI] three-dimensional [3D] T1 volumetric interpolated breath-hold examination [VIBE]), computed tomography (CT) imaging remains the gold standard for diagnosis, with MRI useful for detecting soft tissue pathology. Treatment is predominantly non-operative, focusing on multimodal pain control, early mobilization and structured rehabilitation to restore spinal function while preventing complications. Return-to-play is individualized, with most athletes resuming full activity within 3–6 weeks for isolated TPFs, though multi-level fractures or associated injuries may prolong recovery. TPFs require careful assessment and management to ensure optimal recovery and a safe return-to-play. A multidisciplinary approach involving orthopaedic surgeons, musculoskeletal radiologists, sports physicians, physiotherapists, sport scientists and coaching staff is essential to balance expedient recovery without long-term sequelae. Understanding sport-specific demands and implementing tailored rehabilitation protocols can allow athletes to make a complete recovery with minimal risk of recurrence.