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New Insight Into Fracture Epidemiology in High School Athletes


 

DENVER – More than 568,000 fractures occur annually in U.S. high school athletes who participate in nine major sports, according to a new 4-year study.

Fractures accounted for 10.1% of all high school athletic injuries as well as 27% of all injuries requiring surgery, second only to complete ligament sprains, 30% of which underwent surgical repair, Natalie McIlvain said at the annual meeting of the American Public Health Association.

Foul play as determined by referee, coach, or athletic trainer played a role in 9.3% of all fractures, according to Ms. McIlvain of the center for injury research and policy at Nationwide Children’s Hospital in Columbus, Ohio.

She presented a study in which certified athletic trainers, who were on-site at a nationally representative sample of 100 U.S. high schools, recorded (in an Internet-based data collection tool) all the injuries that were incurred during practice and competition in 2005-2009. The researchers thereby captured the details of 18,316 fractures, which extrapolated to 568,177 fractures occurring annually.

Overall, 16.1% of fractures required surgery. The outliers were boys’ baseball, in which 26% of all fractures required surgery, and girls’ volleyball, in which surgery was needed in only 6% of fractures.

Fractures occurred at an overall rate of 2.48 per 10,000 athletic exposures (defined as one practice or competitive event). The rate was 4.97 fractures per 10,000 AEs during the heat of competition, a rate that was 3.2-fold greater than the rate in practices.

The sport with the highest fracture rate was football (4.61 broken bones per 10,000 AEs) with boys’ wrestling a distant second (2.64), followed by boys’ soccer (2.17). The girls’ sport with the highest fracture rate was basketball (1.38 per 10,000 AEs).

In boys’ and girls’ sports with similar rules and equipment, the boys’ version consistently had higher fracture rates: Boys were 34% more likely to sustain fractures in soccer and 35% more likely than girls to do so in basketball. The fracture rate was 1.61 per 10,000 AEs in boys’ baseball and 1.54 in girls’ softball.

The hands and fingers accounted for 28% of all fractures. The next most frequently fractured body parts were the wrist (10.4%), and the lower leg (9.3%).

In all, 34% of fractures resulted in more than 3 weeks lost from play. Another 24% led to medical disqualification from participation.

Ms. McIlvain’s study was supported by the Centers for Disease Control and Prevention, the National Federation of State High School Associations, DonJoy Orthotics, and EyeBlack. She declared having no relevant financial interests.

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