Acute sports injuries requiring hospital care.

The present investigation reports 138 consecutive patients injured in sports, who needed treatment as in-patients in a one year period. More injuries were sustained in soccer than in other sports. The lower extremity was the site of most injuries, fractures and dislocations being the most common type of injury. At follow-up 50% of the patients complained of discomfort. The average stay in hospital after a sports injury requiring hospital care was 6 days. In 52% of the patients the duration of sports incapacity was at least six months and in seven per cent the sports incapacity after the sustained injury was permanent.     

Imaging of lower extremity trauma from Boston Marathon bombing

The goal of this study is to describe the imaging features of lower extremity blast injuries in patients encountered in the radiology departments from the Boston Marathon bombings. A total of 115 patients presented to four acute care hospitals on April 15, 2013, 43 of whom presented with lower extremity injuries and were included in this study. The imaging findings of primary, secondary, tertiary, and quaternary blast injuries were evaluated. Forty-one of 43 patients sustained secondary blast injuries to the lower extremities with 31 patients (70 %) having retained shrapnel, seven patients (16 %) having soft tissue lacerations without retained shrapnel, and ten patients (23 %) having lower extremity amputation (7 % double amputees). Eight of these patients (20 %) had lower extremity fractures, and five patients (12 %) had vascular injuries. Two of the 43 patients (5 %) had only tertiary injuries, and five of 43 patients (12 %) were noted to have lower extremity burns, consistent with quaternary blast injury. No primary blast injury occurred in the lower extremities. A vast majority of lower extremity injuries were from secondary blast injury, most commonly from retained shrapnel in 70 % of patients and 23 % of patients sustaining lower extremity amputation. Retained shrapnel in the lower extremity was most commonly ball bearings and pressure cooker fragments, and most injuries affected the leg, followed by the thigh and foot.     

Sports injuries in school-aged children. An epidemiologic study

In November 1982, epidemiologic data were collected in a unique, large scale, population-based survey on sports injuries in school-aged children living in Holland. A total of 7,468 pupils, aged 8 to 17, completed questionnaires covering a retrospective period of 6 weeks. Seven hundred ninety-one sports injuries were registered, amounting to an incidence of 10.6 sports injuries per 100 participants. In 31% of the cases, medical consultation was needed. Injuries incurred during the study period caused 36% of the children to miss one or more physical education classes and caused 6% to miss school for at least 1 day. Contusions and sprains were the most common lesions (77%). Three of four injuries involved the lower extremity, in particular the ankle. Sixty-two percent of all the injuries occurred in organized sports, 21% in physical education classes, and 17% in unsupervised sports activities. The highest injury rates were found in basketball and field hockey. In this study population, 15 and 16-year-old boys who had a high sports activity index and played team sports, particularly contact team sports, formed a high risk group.     

Impact of school sports injury

BACKGROUND: Most injuries in school occur during sport. OBJECTIVES: To explore the impact of sports injury in supervised school sport. METHOD: A prospective study of sports injury in children of secondary school age presenting to the accident and emergency department. Each patient was identified on registration, matched with medical records after discharge, and contacted later by telephone to complete a structured interview. Patients were only included if their injury was sustained during supervised school sport. RESULTS: During the study period, 194 patients aged 11-18 attended the accident and emergency department with an injury, 51% of which occurred during school sport. Injuries occurred most commonly in rugby (43%), followed by physical education and games together (17.5%). Most injuries were x rayed (72%). Just over 12% of pupils lost no time from sport, most (71%) were back to sport within three weeks, and 2.7% were injured for more than eight weeks. Almost a third of parents needed to take time off from work to deal with the injured child. CONCLUSION: School sports injuries are important. They account for just over half of all injuries in secondary school children. They cause significant disruption to school and sport and have important implications for the wider family.     

Overuse and traumatic extremity injuries in schoolchildren surveyed with weekly text messages over 2.5 years

The objectives of this prospective cohort study were to report the incidence, prevalence, and duration of traumatic and overuse injuries during a period of 2.5 years and to estimate the odds of injury types. In all, 1259 schoolchildren, aged 6–12, were surveyed each week with an automated mobile phone text message asking questions on the presence of any musculo‐skeletal problems and participation in leisure‐time sport. Children were examined and injuries classified as overuse or traumatic. The overall injury incidence and prevalence were 1.2% and 4.6% per week, with 2.5 times more overuse than traumatic injuries in lower extremities, and mean injury duration of 5.3 and 4.8 weeks, respectively. A reverse pattern was found for upper extremities, with 3.1 times more traumatic than overuse injuries and mean durations of 3.3 and 5.2 weeks, respectively. Grade level, school type, leisure‐time sport, and seasonal variation were associated with the risk of sustaining lower extremity injuries. Only grade level was associated with upper extremity injuries. The magnitude of overuse and traumatic limb injuries emphasizes the need for health professionals, coaches, and parents to pay special attention in relation to the growing and physically active child.     

A systematic review on ankle injury and ankle sprain in sports

This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting injury pattern in 70 sports from 38 countries were included. A total of 201,600 patients were included, with 32,509 ankle injuries. Ankle injury information was available from 14,098 patients, with 11 847 ankle sprains. Results show that the ankle was the most common injured body site in 24 of 70 included sports, especially in aeroball, wall climbing, indoor volleyball, mountaineering, netball and field events in track and field. Ankle sprain was the major ankle injury in 33 of 43 sports, especially in Australian football, field hockey, handball, orienteering, scooter and squash. In sports injuries throughout the countries studied, the ankle was the second most common injured body site after the knee, and ankle sprain was the most common type of ankle injury. The incidence of ankle injury and ankle sprain was high in court games and team sports, such as rugby, soccer, volleyball, handball and basketball. This systematic review provides a summary of the epidemiology of ankle injury in sports.     

Sports-related injuries in elderly men still active in sports.

By means of a questionnaire with a complementary interview and physical examination, the site and nature of sports injuries were investigated over a 10-year period (1977-1987) in 97 elderly athletes (age range 70-81 years). The athletes were still active in training and competition with a mean competition background of 15 years. Of the subjects studied 30 were strength/power athletes and the remaining 67 endurance athletes. Altogether we found 273 sports-related injuries (169 acute and 104 overuse injuries). Of the injuries 75% had occurred in the lower extremities. The most commonly injured part of the body was the knee (20% of all cases). Sprains of the thigh and knee were the most frequent types of acute injury. In most cases the treatment prescribed was rest and physiotherapy. Surgery had been necessary in ten cases (3.7% of all injuries). Mean withdrawal from normal sporting activity had, in general, been 2-3 weeks. Of the injuries, one in five had, however, lasted over several years causing some disability during sporting activities.     

Soccer injuries in Saudi Arabia

Soccer injuries which were seen at the King Fahd University Hospital over a period of 12 months were analyzed. The majority of the patients were under 20 years of age. Two-thirds of the injuries involved soft tissue, while those to the bone and joint comprised one-third. The lower extremity was involved in 59%. Sixteen percent of the injuries were considered severe enough to require inpatient treatment. We feel the high incidence of injuries can be reduced by better guidance and coaching at school and other training levels. At present, these patients are seen in the emergency room of our hospital and subsequently in the orthopaedic and fracture clinics. A specialized sports injury clinic staffed with medical and paramedical personnel with special interest in sports medicine would enable early and effective treatment returning athletes to play without undue delay.     

Risk factors for injury in indoor compared with outdoor adolescent soccer

BACKGROUND: There are limited data on the epidemiology of indoor soccer injuries. PURPOSE: Injury rates and risk factors for injury in adolescent indoor and outdoor soccer in the same cohort of players will be identified and compared. STUDY DESIGN: Cohort study (prevalence); Level of evidence, 2. METHODS: The study population was a random sample of 21 adolescent (ages 13-17 years) outdoor soccer teams (N = 317). The subcohort included players continuing to play in the indoor soccer season (n = 142). The injury definition included any injury occurring in soccer that resulted in medical attention, the inability to complete a session, and/or missing a subsequent session. RESULTS: The overall injury rate found in indoor soccer over 20 weeks was 4.45 injuries per 1000 player hours (95% confidence interval, 3.1-6.19). The overall injury rate found in the 13-week outdoor soccer season among a similar cohort was 5.59 injuries per 1000 player hours (95% confidence interval, 4.42-6.97). The relative risk of injury suggests that there was no significant difference between injury rates by age group or gender in indoor soccer compared with outdoor soccer. The risk of injury in the most elite division of play was greater in outdoor compared with indoor soccer (relative risk, 3.22; 95% confidence interval, 1.8-6.12). The most commonly injured body part in both indoor and outdoor soccer was the ankle, followed by the groin in indoor and the knee in outdoor soccer. CONCLUSION: There were no significant differences in overall injury rates found by gender or age group for indoor compared with outdoor soccer. Future research should focus on injury prevention strategies to reduce lower extremity injury in indoor and outdoor adolescent soccer.     

The role of core stability in the development of non-contact acute lower extremity injuries in an athletic population: A prospective study

ObjectivesStability of the core is associated with lower extremity functioning. Consequently, impaired core stability might play a role in developing non-contact acute lower extremity sports injuries. The objective was to investigate components of core stability as potential risk factors for acute lower extremity injuries.DesignA cohort study was set up with a follow-up and injury registration period of 1.5 years.Participants142 male and female physical education students were included.Main outcome measuresMeasures of isometric hip and core muscular strength, endurance, proprioception and neuromuscular control of the core, and postural control were taken at the start of the study. Sports-related injury occurrence was registered during follow-up.Results27 (19%) injuries of interest occurred during follow-up. After multivariate model building, a significant predictive effect was found for side-to-side hip abduction strength asymmetry (p = .007). The hazard of developing an acute lower extremity injury increased with 6.2% with a 1 unit increase in side-to-side strength imbalance, regardless of gender.ConclusionHip abduction strength imbalance was determined as a risk factor for the development of non-contact, acute lower extremity injuries. Normalizing hip strength imbalances might be beneficial for injury prevention. However, further research is needed to support this claim.     

Epidemiology and traumatology of injuries in elite soccer: a prospective study in Finland

A prospective study of male soccer injuries among 12 teams playing at the highest competition level was carried out in Finland in 1993. Overall, two out of three players were injured during the whole season. The injury incidence per 1000 playing hours among injured players and all players during games was higher than during practice, 14.2 vs. 11.3 and 2.3 vs. 1.8, respectively. The lower extremity was involved in 76% of the injuries. Thigh injuries were most frequent (22%), whereas overuse injuries were scarce (6%). Eighteen per cent of the injured players needed surgery and in most cases (58%) the reason for surgery was a knee injury. Sixteen per cent of all injured players were absent from soccer for more than 1 month after the injury. The mean absence time was 17 days for all and 84 days for operatively treated players.     

The public health impact of injury during sport and active recreation

Injuries can be an adverse outcome of participation in sport and recreational activities. The aim of this study was to determine the public health impact of injury during sports and active recreation injury in a select population in Australia. A random household telephone survey was conducted quarterly over a 12-month period in a well-defined geographic region, the Latrobe Valley, Australia. Information was collected on participation in sport and active recreation and associated injuries over the previous 2 weeks for all household members aged over 4 years. Injury rates were calculated per 10,000 population and per 1000 sports participants. Data were collected on 1084 persons from 417 households. Overall, 648 people reported participating in at least one sport or active recreation and 34 (5.2%, 95% CI: 4.8, 5.6%) of these sustained an injury during this activity. Overall, 51.4% of injured cases had a significant impact: 26.5% sought treatment, 34.4% had their activities of daily living adversely affected and 36.0% had their performance/participation limited. Cricket (51 injuries/10,000 population), horse riding (29/10,000 population) and basketball (25/10,000 population) had the highest injury rates. After adjusting for participation, cricket (242 injuries/1000 participants), horse riding (122/1000 participants) and soccer (107/1000 participants) had the highest injury rates. Cricket and soccer were the sports most associated with ‘significant’ injuries. Injury prevention efforts should be aimed at team ball sports (especially cricket, soccer and netball) because of their comparatively high rate of both overall and ‘significant’ injury.     

Injuries to the upper extremity in ice hockey: analysis of a series of 760 injuries

BACKGROUND: Injuries to the upper extremity are common in ice hockey. PURPOSE: To investigate the mechanisms, types, and severity of upper extremity ice hockey injuries in patients in different age categories. STUDY DESIGN: Retrospective cohort study. METHODS: We analyzed 760 consecutive upper extremity injuries in Finnish ice hockey players reported to an insurance company during 1996. RESULTS: The overall injury rate of upper extremity injuries was 14.8 per 1000 player-years; 70% occurred during games. Of the 861 injury types, 32% were contusions, 28% sprains or strains, and 27% fractures. Checking or other collisions with players caused 76% of the injuries to the shoulder (170 of 223), 55% of the injuries to the elbow (35 of 64), and 45% of the injuries to the distal extremity (213 of 473). Of the 561 injuries with known severity, 38% were major. The injury risk increased significantly with age, from players younger than 12 years to players 25 to 29 years of age. The injury profile among 15- to 19-year-old players was similar to that of adult players. CONCLUSIONS: Injuries to the upper extremity are relatively serious because of the high number of shoulder injuries and fractures. The frequency of injuries increased with age. A considerable proportion of upper extremity injuries was caused by body checking.     

Snowboard injuries

A retrospective survey of 267 snowboarders was undertaken to determine the population at risk and types and mechanisms of injuries sustained in this sport. Snowboarders are young (average age, 21 years), male (greater than 90%), view themselves in average or above average physical condition (96%), and have varied sports interests. One hundred ten injuries that resulted in a physician visit were reported. Ligament sprains, fractures, and contusions were the most frequent types of injury. Fifty percent of all injuries occurred in the lower extremities, with ankle injuries being the most common. Snowboard riders using equipment with increased ankle support seem to be more protected from lower extremity injuries. The lower extremity injuries were concentrated in the forward limb of the snowboarder, where the rider's weight is disproportionately distributed. Differences in the mechanism and spectrum of injury between snowboarding and skiing injuries were noted, including: impact rather than torsion as the major mechanism of injury, a significant lack of thumb injuries, comparative increase in ankle injuries, a decrease in knee injuries, and a higher percentage of upper extremity injuries.     

Caught on camera: a video assessment of suspected concussion and other injury events in women's rugby union

ObjectivesThe objective of this study was to identify and report the incidence and mechanisms of suspected injury and concussion in women's rugby union.DesignA cross-sectional video analysis study.MethodsUsing video analysis of non-professional, single-angle footage, cases of suspected injury and concussion were identified and reported, based on content validation and consensus by eight rugby-specific researchers, therapists, and sport medicine physicians.ResultsThere were 225 suspected injuries recorded in 48 games [Suspected injury rate (IR) = 117.5/1000 h (95 % CI;102.6–133.9) or 4.7 suspected injuries per match]. The on-field medical attention IR was 95.0/1000 h (95 % CI;81.7–109.9: 3.8 per game). Suspected concussions accounted for 26 % of injuries (30.8/1000 h: 95 % CI;23.5–39.7: 1.2 per game). The attacking team sustained 64 % of suspected injuries. Permanent removal from play was observed for 29 % of suspected injuries. The most common suspected injury locations were head/neck (28.4 %) and lower extremity (27.6 %). The tackle accounted for 67.1 % of all suspected injuries, with a propensity of 11.2/1000 tackle events (95 % CI;9.5–13.2) or 3.1 tackle-related injuries/game. Of tackle-related injuries, 63.6 % were to the ball carrier while 52.2 % of tackle-related concussions were to the ball carrier.ConclusionThis study adds to the growing body of literature examining women's rugby. The rate of suspected injury is high compared with other studies. It is acknowledged that these are suspected injuries not supported by prospective injury surveillance. The high proportion of suspected injuries that are tackle-related warrants specific attention to identify tackle characteristics associated with injury and concussion.     

The Harstad injury prevention study: the epidemiology of sports injuries. An 8 year study.

OBJECTIVE--To describe the epidemiology of sports injuries occurring in a community during 8 years and to evaluate the outcome of an intervention implemented against injuries occurring in downhill skiing. METHODS--Hospital treated sports injuries occurring in Harstad, Norway (population 22 600) were recorded prospectively during an 8 year period. A prevention programme targeting downhill skiing injuries was evaluated. RESULTS--2234 sports injuries accounted for 17.2% of recorded unintentional injuries. Two out of three injuries occurred in team sports. Soccer accounted for 44.8% of all sports injuries. Downhill skiing injuries had higher mean score on the abbreviated injury scale than all other sports analysed combined (P < 0.01). Postintervention injury rates for downhill skiing were reduced by 15% when adjusting for exposure (P = 0.24). Further observations are needed for assessing the effectiveness of the downhill skiing safety programme. CONCLUSIONS--Strategies for future sports injury prevention include community involvement, particularly sports organisations. Local data analysis seems to justify some priorities, for example, promotion of helmet use in downhill skiing for young adolescents and prevention of lower limb fractures in male soccer players 15+ years old. Prospective hospital recording of injuries provides a tool for the design and outcome evaluation of sports injury intervention research.     

Injuries in team sport tournaments during the 2004 Olympic Games

BACKGROUND: Several authors have analyzed the incidence of injuries in a given sport, but only a few have examined the exposure-related incidence of injuries in different types of sports using the same methodology. PURPOSE: Analysis of the incidence, circumstances, and characteristics of injuries in different team sports during the 2004 Olympic Games. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: During the 2004 Olympic Games, injuries in 14 team sport tournaments (men's and women's soccer, men's and women's handball, men's and women's basketball, men's and women's field hockey, baseball, softball, men's and women's water polo, and men's and women's volleyball) were analyzed. After each match, the physician of the participating teams or the official medical representative of the sport completed a standardized injury report form. The mean response rate was 93%. RESULTS: A total of 377 injuries were reported from 456 matches, an incidence of 0.8 injuries per match (95% confidence interval, 0.75-0.91) or 54 injuries per 1000 player matches (95% confidence interval, 49-60). Half of all injuries affected the lower extremity; 24% involved the head or neck. The most prevalent diagnoses were head contusion and ankle sprain. On average, 78% of injuries were caused by contact with another player. However, a significantly higher percentage of noncontact (57%) versus contact injuries (37%) was expected to prevent the player from participating in his or her sport. Significantly more injuries in male players (46%) versus female players (35%) were expected to result in absence from match or training. The incidence, diagnosis, and causes of injuries differed substantially between the team sports. CONCLUSION: The risk of injury in different team sports can be compared using standardized methodology. Even if the incidence and characteristics of injuries are not identical in all sports, prevention of injury and promotion of fair play are relevant topics for almost all team sports.     

Foot morphology and foot/ankle injury in indoor football

While the pronated foot is implicated as a risk factor for sports injury in some studies, others suggest that a supinated foot posture increases the risk of overuse lower limb injuries. Athletes in a given sports discipline may tend to have a similar foot morphology, which varies from that observed elsewhere. Further, the foot morphology that is beneficial for performance in a sport may be detrimental with regard to injury. Intra- and inter-rater reliability of the Foot Posture Index (FPI-6) as a measure of foot morphology was determined (ICC (2,1) 0.88 and 0.69 respectively). Thereafter, in a prospective cohort study using the FPI-6, 76 adolescent male indoor football (Futsal) players were measured and followed monthly over one competition season. Coach-rated ability and reports of any overuse injuries at the ankle and/or foot over this period were obtained. A significant negative linear relationship was found between the mean FPI-6 scores and coach-rated ability (p=0.008), with supinated and under-pronated postures related to higher ability level. Overall, 33% of injuries at the ankle and/or foot were classified as overuse. Foot Posture Index scores of less than 2, indicating the supinated and under-pronated feet, were found to be associated with a significant increase in the risk of overuse injury (p=0.008). The greater rigidity of these foot types may assist adolescent, male, indoor football players to perform at a higher level in their sport. Unfortunately, these players are also more likely to sustain ankle and/or foot overuse injuries.     

An epidemiologic and traumatologic study of injuries in handball

To identify the risk factors of injuries in handball, 221 players were followed during one indoor season. The injury incidence was 4.6/1000 playing hours and 11.4/1000 game hours. The upper extremity was involved in 41% of the injuries including 21% finger sprains. Ankle sprains were the most common injury (33%), and overuse injuries accounted for 18%. The risk of reinjury was 32%. Contact with opponent players during running or shooting caused 31% of the injuries. Errors during grasping the ball were the reason for most of the finger injuries. Forty percent of the injuries was treated by the players themselves. After the injury 73% were absent from handball for more than 1 week. Forty-one percent of the injured players had complaints 6 months after the end of the season. The study shows that injuries in handball are serious and cause extensive consequences for the players. In most of the injuries both intrinsic and extrinsic factors were involved, and prophylactic intervention in these cases demands changes in more fields.     

Knee injuries in leisure-time physical activities: a prospective one-year follow-up of a Finnish population cohort

This prospective one-year follow-up study compared the risks of knee injuries in various commuting and lifestyle activities as well as in recreational and competitive sports in a 15 to 74-year-old Finnish population cohort. A cohort of 3657 persons was randomly selected from the nationwide population register of Finland. Ninety-two percent of them accepted to participate (n = 3363). The subjects were interviewed by telephone three times during the one-year follow-up. The recorded data included all physical activities that lasted 15 minutes or more, and all injuries that were sustained during these activities. Fifteen percent (n = 321) of all reported injuries affected the knee. The individual risk of knee injury per 1000 exposure hours was low in commuting activities (cycling, walking), 0.06 (95 % CI 0.04 to 0.09) and in lifestyle activities (gardening, hunting, fishing, home repair etc.), 0.04 (0.03 - 0.06). In recreational and competitive sports, the knee injury risk was almost ten times higher, 0.44 (0.39 - 0.50). For commuting activities (p = 0.046) and for recreational and competitive sports (p < 0.001), there was a decreasing injury rate with age. In lifestyle activities (p = 0.038), in turn, there was an increasing trend of injuries with aging. In commuting activities (hazard ratio, HR 5.99, 95 % CI 1.40 to 25.6), the risk of knee injury was significantly higher in women than in men. In conclusion, the knee injury risk per exposure hours is almost ten times lower in commuting and lifestyle activities compared to recreational and competitive sports. The knee injury risk is especially high in the age group of 15 to 25 years, especially in various team sports and ball games. At population level, however, widely practiced low-to-moderate intensity activities with relatively low injury risk per exposure hours produce a large absolute number of knee injuries.