Summary

This study is an epidemiological analysis of dislocations, fractures, sprains, and strains in adolescent and young adult contact sport players within a 10-year timeframe using the NEISS injury database.

Abstract

OBJECTIVES: This study aimed to determine general incidence rate patterns and the nature of musculoskeletal injuries in contact sports. We hypothesized that disparities exist in the rates, types, distribution, and severity of injuries among young adult athletes in contact sports.

Methods

We conducted our analysis using data from the National Electronic Injury Surveillance System (NEISS) from 2014 to 2023. Males and females aged 15 to 25 years presented to emergency departments with musculoskeletal injuries derived from basketball, soccer, rugby, and ice hockey. Injuries were classified into three categories: dislocations, strains/sprains, and fractures. Body parts injured were grouped into upper extremity, lower extremity, face/neck, and trunk. Race was categorized into seven groups. Age was categorized into 3 distinct groups (15-18, 18-21, 21-25). The annual incidence rate of injuries per 100,000 population was calculated using U.S. Census population data. Chi-square tests of independence and logistic regression models were used to analyze associations and calculate odds ratios (OR) for factors related to injury patterns and hospitalization.

Results

The analysis included 45,917 reported cases and a weighted estimate of 1,532,982. The 15-18 age group accounted for 63.1% of injuries, with basketball being the most common sport (71.5% of injuries), followed by soccer (25.1%), rugby (1.8%), and ice hockey (1.7%). Mean age varied by sport: rugby (19.16 years), basketball (18.24 years), soccer, and ice hockey (both 17.95 years). Sprains/strains were the most common injury type (66.3%), followed by fractures (24.9%) and dislocations (8.8%). The most frequent injury locations were ankle (38.5%), knee (14.0%), and finger (10.2%), with lower extremity injuries being most common overall (62.5%), followed by upper extremity (29.6%). Overall, the 21-25 age group had the highest odds of hospitalization (OR 0.844, 95% CI 0.801-0.890). Body parts most likely to result in hospitalization were upper leg (OR 19.44, 95% CI: 18.02-20.96), neck (OR 7.27, 95% CI: 6.32-8.35), and lower leg (OR 4.01, 95% CI: 3.83-4.19). Overall annual incidence rates declined until 2020, reaching the lowest point during the COVID-19 pandemic (R² = 0.824; p<0.001). Injury frequencies generally decreased as age increased (R² = 0.903), except in rugby, and monthly trends aligned with typical competition seasons. Upper extremity injuries in males more often resulted in fractures, while females commonly experienced sprains and strains. No significant patterns or disparities were observed between racial groups in the weighted estimates.

Conclusion

This analysis reveals significant disparities in musculoskeletal injury patterns among young adult contact sports players. The prevalence of injuries in 15-18-year-olds underscores the need for targeted prevention strategies in adolescents. Variations in injury between sports and genders highlight the importance of tailored approaches to injury prevention and treatment. Body parts associated with higher hospitalization risks provide crucial information for acute care management. These findings offer valuable insights for developing appropriate interventions to enhance athlete safety in contact sports.