PEAK LOWER EXTREMITY SOCCER INJURIES OCCUR IMMEDIATELY FOLLOWING GROWTH IN ADOLESCENTS: AN EPIDEMIOLOGIC REVIEW OF EMERGENCY DEPARTMENT VISITS

BACKGROUND: Soccer has become the most popular youth sport in the world. Within the last decade, there has been limited epidemiologic research on pediatric soccer-related injuries based on sex and age. PURPOSE: To examine trends associated with soccer injuries presenting to emergency departments and to describe differences in injury pattern and location based on sex and age during periods of growth. METHODS: An epidemiologic study was conducted utilizing publicly accessible data from the National Electronic Injury Surveillance System (NEISS). The NEISS compiles Emergency Department (ED) data on all injuries presenting to the approximately 100 participating network hospitals in the United States. Information on all soccer-related injuries occurring in ages 7-19 from January 2009 – December 2018 was extracted and summary statistics were calculated. RESULTS: Approximately 54,287 pediatric soccer-related injuries were identified. The average age for all injuries was 13.3 years, and males (60.50%) presented more often than females (39.50%). Concussions and head injuries (15.57%) were most commonly reported overall, with a greater percentage occurring in females than males (17.44% vs. 14.35%). The ankle (15.3%) was the second most common injury location with females also presenting more commonly than males (18.71% vs. 13.62%). Age and sex-based evaluation noted peaks in lower extremity injuries in females younger than in males. Both ankle (F=13-15 years, M=15-17 years) and knee (F=14 years, M=16 years) injuries peaked at ages coinciding with recognized sex-based lower extremity skeletal maturity (Figure 1). CONCLUSION: Peak pediatric soccer-related ankle and knee injuries presenting to emergency departments occur at different ages in females and males and appear to, on average, coincide with maturation (age 14 in females and 16 in males). Lower extremity injuries significantly increase nearing the completion of lower extremity growth, and may indicate appropriate timing for differential sex-specific injury prevention programs within soccer. [Figure: see text]

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Epidemiology of Pediatric Baseball and Softball Player Injuries

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211052585 ◽

2021 ◽

Vol 9 (12) ◽

pp. 232596712110525

Author(s):

Ali S. Farooqi ◽

Alexander Lee ◽

Eric Abreu ◽

Divya Talwar ◽

Kathleen J. Maguire

Keyword(s):

Lower Extremity ◽

Sports Injuries ◽

The United States ◽

Injury Surveillance System ◽

Baseball Players ◽

Injury Rates ◽

Lower Extremity Injuries ◽

Youth Baseball ◽

Extremity Injuries ◽

Head Neck

Background: Baseball and softball are popular sports in the United States and are responsible for a large number of youth sports injuries each year. Purpose: To investigate recent differences in youth baseball and softball injuries evaluated in nationwide emergency departments. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System (NEISS) database was examined for softball and baseball injuries in pediatric patients (age, 7-21 years) from 2010 through 2019. Patients were classified as children (age, 7-13 years), adolescents (age, 14-18 years), or young adults (age, 19-21 years). Case narratives were used to categorize injuries as contact injuries (hit by bat or ball), field injuries (sliding into base, collision with another player, catching, or running), throwing injuries, or other. Results: An unweighted total of 24,717 baseball injuries and 13,162 softball injuries were recorded. A nationwide estimate of 861,456 baseball injuries and 511,117 softball injuries were sustained during the studied time period, with estimated respective injury rates of 86,146 and 51,112 per year. Injured softball players were most commonly adolescent (47%) and female (92%), while injured baseball players were most commonly children (54%) and male (90%). There was a greater proportion of baseball-related injuries involving the head/neck (41%) as compared with softball-related injuries (30%) ( P < .01). Conversely, a greater proportion of softball-related injuries involved the lower extremity (32%) as compared with baseball-related injuries (19%) ( P < .01). When comparing diagnosis, softball injuries were more often sprains/strains (28%) than baseball injuries (18%) ( P < .01). When comparing mechanisms of injury, baseball athletes were more likely to be evaluated with contact injuries than were softball athletes (49% vs 40%, P < .01). Conclusion: Youth baseball athletes were more likely to be injured through contact mechanisms and had a higher proportion of injuries related to the head/neck/face, whereas softball injuries more frequently involved the lower extremity and resulted in a sprain/strain. League guidelines should focus on reducing contact injuries within youth baseball, and injury-prevention programs should focus on reducing lower extremity injuries in youth softball.

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Child Development and Pediatric Sport and Recreational Injuries by Age

Journal of Athletic Training ◽

10.4085/1062-6050-49.3.41 ◽

2014 ◽

Vol 49 (6) ◽

pp. 780-785 ◽

Cited By ~ 21

Author(s):

David C. Schwebel ◽

Carl M. Brezausek

Keyword(s):

United States ◽

Emergency Department ◽

Emergency Departments ◽

Injury Risk ◽

The United States ◽

Emergency Department Visits ◽

Sociocultural Factors ◽

Childhood And Adolescence ◽

Injury Surveillance System ◽

Sport And Recreation

Context: In 2010, 8.6 million children were treated for unintentional injuries in American emergency departments. Child engagement in sports and recreation offers many health benefits but also exposure to injury risks. In this analysis, we consider possible developmental risk factors in a review of age, sex, and incidence of 39 sport and recreational injuries. Objective: To assess (1) how the incidence of 39 sport and recreational injuries changed through each year of child and adolescent development, ages 1 to 18 years, and (2) sex differences. Design Descriptive epidemiology study. Setting: Emergency department visits across the United States, as reported in the 2001–2008 National Electronic Injury Surveillance System database. Patients or Other Participants: Data represent population-wide emergency department visits in the United States. Main Outcome Measure(s) Pediatric sport- and recreation-related injuries requiring treatment in hospital emergency departments. Results: Almost 37 pediatric sport or recreational injuries are treated hourly in the United States. The incidence of sport- and recreation-related injuries peaks at widely different ages. Team-sport injuries tend to peak in the middle teen years, playground injuries peak in the early elementary ages and then drop off slowly, and bicycling injuries peak in the preteen years but are a common cause of injury throughout childhood and adolescence. Bowling injuries peaked at the earliest age (4 years), and injuries linked to camping and personal watercraft peaked at the oldest age (18 years). The 5 most common causes of sport and recreational injuries across development, in order, were basketball, football, bicycling, playgrounds, and soccer. Sex disparities were common in the incidence of pediatric sport and recreational injuries. Conclusions: Both biological and sociocultural factors likely influence the developmental aspects of pediatric sport and recreational injury risk. Biologically, changes in perception, cognition, and motor control might influence injury risk. Socioculturally, decisions must be made about which sport and recreational activities to engage in and how much risk taking occurs while engaging in those activities. Understanding the developmental aspects of injury data trends allows preventionists to target education at specific groups.

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A Descriptive Analysis of Location of Older Adult Falls That Resulted in Emergency Department Visits in the United States, 2015

American Journal of Lifestyle Medicine ◽

10.1177/1559827620942187 ◽

2020 ◽

pp. 155982762094218

Author(s):

Briana L. Moreland ◽

Ramakrishna Kakara ◽

Yara K. Haddad ◽

Iju Shakya ◽

Gwen Bergen

Keyword(s):

United States ◽

Older Adults ◽

Emergency Department ◽

The United States ◽

Emergency Department Visits ◽

Targeted Prevention ◽

Injury Surveillance System ◽

Injurious Falls ◽

Ed Visits ◽

At Home

Introduction. Falls among older adults (age ≥65) are a common and costly health issue. Knowing where falls occur and whether this location differs by sex and age can inform prevention strategies. Objective. To determine where injurious falls that result in emergency department (ED) visits commonly occur among older adults in the United States, and whether these locations differ by sex and age. Methods. Using 2015 National Electronic Injury Surveillance System-All Injury Program data we reviewed narratives for ED patients aged ≥65 who had an unintentional fall as the primary cause of injury. Results. More fall-related ED visits (71.6%) resulted from falls that occurred indoors. A higher percentage of men’s falls occurred outside (38.3%) compared to women’s (28.4%). More fall-related ED visits were due to falls at home (79.2%) compared to falls not at home (20.8%). The most common locations for a fall at home were the bedroom, bathroom, and stairs. Conclusion. The majority of falls resulting in ED visits among older adults occurred indoors and varied by sex and age. Knowing common locations of injurious falls can help older adults and caregivers prioritize home modifications. Understanding sex and age differences related to fall location can be used to develop targeted prevention messages.

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Facial Fractures in Young Adults: A National Retrospective Study

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489419830114 ◽

2019 ◽

Vol 128 (6) ◽

pp. 516-523 ◽

Cited By ~ 3

Author(s):

Roman Povolotskiy ◽

Pavly Youssef ◽

Rachel Kaye ◽

Boris Paskhover

Keyword(s):

United States ◽

Emergency Department ◽

Young Adults ◽

Young Adult ◽

The United States ◽

Emergency Department Visits ◽

Injury Incidence ◽

Facial Fractures ◽

Injury Surveillance System ◽

Maxillofacial Fractures

Objectives: “Young adulthood” is a term used to define individuals falling within the 18- to 22-year-old age range. Injuries account for more than a third of emergency department visits in this population. A particular area of concern is accidents that lead to injuries of the facial bones because they can have long-term functional, aesthetic, and psychosocial impacts. As many as 30 million young adults participate in some sort of sport in the United States per year, and facial injuries from these activities are not uncommon and thus require further exploration. Methods: The National Electronic Injury Surveillance System was used to conduct a retrospective review to explore patterns of maxillofacial fractures in young adult patients between the ages of 18 and 22 years from 2004 through 2017. The data analyzed yielded information about patient demographics, diagnoses, and associated products. Results: A total of 3486 emergency department visits were included in the study. The most common facial fractures were nasal fractures (64.4%), mandible fractures (12.3%), and orbital fractures (6.1%). The most common causes of fractures were sports (55.48%), fixed structures (6.39%), and stairs or steps (5.60%). The top 3 sports associated with facial fractures were basketball (25.4%), baseball (11.6%), and football (10.4%). Conclusions: For young adult individuals, some sort of sporting activity is common outside of the National Collegiate Athletic Association. The overwhelming majority of facial fractures in this population were caused by sports, and the authors believe this issue warrants further exploration and discussion. According to the Centers for Disease Control and Prevention, an estimated 8.6 million sports- and recreation-related injuries occurred per year between 2011 and 2014. Despite ever growing research and guidelines into sports injury incidence and prevention, it is clear that sports are the cause of a large portion of maxillofacial fractures in the United States.

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The Demographics of Fractures and Dislocations Across the Entire United States due to Common Sports and Recreational Activities

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738119882930 ◽

2019 ◽

Vol 12 (2) ◽

pp. 159-169

Author(s):

Cory Meixner ◽

Randall T. Loder

Keyword(s):

United States ◽

Emergency Department ◽

Multivariate Logistic Regression Analysis ◽

The United States ◽

Emergency Department Visits ◽

Level Of Evidence ◽

Injury Surveillance System ◽

Joint Dislocation ◽

Recreational Activities ◽

Inline Skating

Background: There exists little nationwide data regarding fracture and dislocation patterns across a wide variety of sporting activities for all ages and sexes. Hypothesis: Participant demographics (age and sex) will vary with regard to fracture and joint dislocation sustained during sport-related activities. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: The National Electronic Injury Surveillance System All Injury Program data 2005 through 2013 were accessed; 18 common sports and recreational activities in the United States were selected. Statistical software was used to calculate the numbers of fractures and dislocations, and incidence was calculated using US Census Bureau data. Multivariate logistic regression analysis determined the odds ratios (ORs) for the occurrence of a fracture or dislocation. Results: A fracture occurred in 20.6% and a joint dislocation in 3.6% of the emergency department visits for sports-related injuries; annual emergency department visit incidence was 1.51 for fractures and 0.27 for dislocations (per 1000 people). Most of the fractures occurred in football (22.5%). The OR for fracture was highest for inline skating (OR, 6.03), males (OR, 1.21), Asians, whites, and Amerindians compared with blacks (OR, 1.46, 1.25, and 1.18, respectively), and those older than 84 years (OR, 4.77). Most of the dislocations occurred in basketball (25.7%). The OR for dislocation was highest in gymnastics (OR, 4.08), males (OR, 1.50), Asians (OR, 1.75), and in those aged 20 to 24 years (OR, 9.04). The most common fracture involved the finger, and the most common dislocation involved the shoulder. Conclusion: Inline skating had the greatest risk for fracture, and gymnastics had the greatest risk for joint dislocation. Clinical Relevance: This comprehensive study of the risks of sustaining a fracture or dislocation from common sports activities across all age groups can aid sports health providers in a better understanding of those sports at high risk and be proactive in prevention mechanisms (protective gear, body training).

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Epidemiology of Upper Extremity Soccer Injuries Among High School– and College-Aged Players in the United States: An Analysis of the 1999-2016 NEISS Database

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738118795483 ◽

2018 ◽

Vol 10 (6) ◽

pp. 552-557 ◽

Cited By ~ 2

Author(s):

Wesley M. Durand ◽

Avi D. Goodman ◽

Patricia Giglio ◽

Christine Etzel ◽

Brett D. Owens

Keyword(s):

High School ◽

Upper Extremity ◽

The United States ◽

High Energy ◽

Soccer Players ◽

Level Of Evidence ◽

Injury Surveillance System ◽

Aged Patients ◽

Lower Extremity Injuries ◽

Extremity Injuries

Background: Although lower extremity injuries are more common than upper extremity injuries in high school– and college-aged soccer players, upper extremity injuries may be equally severe. The epidemiology of upper extremity injuries is poorly characterized in this population. Hypothesis: Upper extremity injuries are an important contributor to soccer-related morbidity among high school– and college-aged players. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: The National Electronic Injury Surveillance System (NEISS) is a nationally representative sample of 100 hospital emergency departments (EDs). Each record contains demographic and injury information. Records from 1999 to 2016 were analyzed, including patients between the ages of 14 and 23 years with a soccer-related injury sustained at school or during an athletic event. Results: A total of 1,299,008 high school– or college-aged patients presented to the ED for a soccer-related injury from 1999 to 2016, of which 20.4% were in the upper extremity. Patients were predominantly male (58.0%) and high school–aged (81.4%). Males constituted a greater proportion of upper extremity injuries when compared with other injury locations (63.5% male for upper extremity). Upper extremity injuries were more likely to be fractures (43.7% vs 13.9%) and dislocations (7.1% vs 3.4%) and less likely to be strains/sprains (27.8% vs 56.6%). Males suffered more shoulder dislocations (81.8% males among patients with shoulder dislocation vs 57.8% among those with other injuries), finger dislocations (72.0% vs 58.0%), upper arm fractures (74.9% vs 57.6%), and forearm fractures (68.3% vs 57.3%). Conclusion: Upper extremity injuries are frequent in high school– and college-aged soccer players presenting to the ED. Efforts to reduce soccer-related injuries should include strategies targeting the upper extremity, perhaps reducing the incidence of high-energy falls. Clinical Relevance: Efforts to reduce soccer-related injuries should include strategies targeting upper extremity injuries, particularly among males and college-aged players.

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How to Create a Hot Foot Line to Prevent Diabetes-Related Amputations: Instant Triage for Emergency Department and Inpatient Consultations

Journal of the American Podiatric Medical Association ◽

10.7547/17-204 ◽

2019 ◽

Vol 109 (2) ◽

pp. 174-179

Author(s):

John D. Miller ◽

Eric J. Lew ◽

Nicholas A. Giovinco ◽

Christian Ochoa ◽

Vincent L. Rowe ◽

...

Keyword(s):

Emergency Department ◽

Lower Extremity ◽

Admission Rate ◽

The United States ◽

Adverse Outcomes ◽

Emergency Department Visits ◽

Tissue Loss ◽

Hospital Admission Rate ◽

Team Members ◽

Below The Knee

Emergency department visits for lower extremity complications of diabetes are extremely common throughout the world. Surprisingly, recent data suggest that such visits generate an 81.2% hospital admission rate with an annual bill of at least $1.2 billion in the United States alone. The likelihood of amputation and other subsequent adverse outcomes is strongly associated with three factors: 1) wound severity (degree of tissue loss), 2) ischemia, and 3) foot infection. Using these factors, this article outlines the basic principles needed to create an evidence-based, rapid foot assessment for diabetic foot ulcers presenting to the emergency department, and suggests the establishment of a “hot foot line” for an organized, expeditious response from limb salvage team members. We present a nearly immediate assessment and referral system for patients with atraumatic tissue loss below the knee that has the potential to vastly expedite lower extremity triage in the emergency room setting through greater collaboration and organization.

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Trampoline Related Injuries

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00213 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0021

Author(s):

Jesse Doty ◽

Ryan Voskuil ◽

Rachel Swafford

Keyword(s):

Lower Extremity ◽

Hospital Admissions ◽

The United States ◽

Published Data ◽

Lower Extremity Injuries ◽

Patient Demographics ◽

Included Patient ◽

Period Data ◽

Domestic Setting ◽

Extremity Injuries

Category: Trauma Introduction/Purpose: Jump parks (or trampoline parks) have become one of the fastest growing recreational businesses in the United States. With their increasing popularity, notable changes in trampoline related injuries might be evident, particularly involving the lower extremity. There is no published data dedicated to adult trampoline injuries and little information regarding the safety profiles of commercial jump parks. Methods: We conducted a retrospective review including all patients sustaining trampoline related injuries presenting during a two-year period. Data collection included patient demographics and injury characteristics of trampoline injuries in the domestic setting and at commercial jump parks. Results: One hundred fifty patients (34%) sustained injuries at commercial jump parks versus 289 patients (66%) on home trampolines. Fifty-five percent of the jump park injuries were fractures/dislocations, compared to 44% of the home trampoline injuries. Eighteen adults sustained fractures or dislocations at the jump park (45%), while only five adults sustained fractures or dislocations using home trampolines (17%). Seventeen (94%) and 2 (40%) represented adult lower extremity injuries in jump parks and home trampolines respectively. In children, 47 (72%) of the jump park fractures/dislocations were lower extremity, and 41 (33%) of the home trampoline fractures/dislocations were lower extremity. Ten (9%) pediatric and 9 (23%) adult jump park patients required operative intervention, compared to 17 (7%) pediatric and 3 (10%) adult home trampoline patients requiring surgery. Conclusion: Emergency room visits, hospital admissions, and surgical intervention secondary to jump park related injuries are not uncommon in children and adults. There were a higher percentage of total fractures or dislocations, adult fractures, lower extremity fractures, and operative interventions among patients with commercial jump park injuries compared with those who sustained home trampoline injuries.

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Pediatric Sports- and Recreation-Related Dental Injuries Treated in US Emergency Departments

Clinical Pediatrics ◽

10.1177/0009922819853768 ◽

2019 ◽

Vol 58 (11-12) ◽

pp. 1262-1270 ◽

Cited By ~ 1

Author(s):

Efrain Montero ◽

Sandhya Kistamgari ◽

Thitphalak Chounthirath ◽

Nichole L. Michaels ◽

Motao Zhu ◽

...

Keyword(s):

Emergency Department ◽

Confidence Interval ◽

Emergency Departments ◽

Surveillance System ◽

Emergency Department Visits ◽

Injury Surveillance ◽

Injury Surveillance System ◽

Dental Injury ◽

Using Data ◽

Dental Injuries

This study investigated characteristics and trends associated with sports- and recreation-related dental injuries among children <18 years old treated in US emergency departments using data from the National Electronic Injury Surveillance System for 2000 to 2017. There were an estimated 198 787 (95% confidence interval = 162 216-235 358) injuries during the study period, averaging 11 044 injuries annually. The rate of dental injuries per 100 000 US population <18 years old fluctuated during the study, starting at 16.9 in 2000 and ending at 13.9 in 2017. Injuries most commonly occurred among males (69.8%) and children 7 to 12 years old (44.6%). Pediatric sports- and recreation-related dental injuries were most commonly associated with bicycles (28.6%), playground equipment (15.3%), and baseball/softball (12.4%). Although emergency department visits for pediatric sports- and recreation-related dental injuries decreased during the study period overall, sports and recreation remain an important source of preventable dental injury, particularly among children 7 to 12 years old.

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Pediatric Hand and Upper Extremity Injuries Presenting to Emergency Departments in the United States: Epidemiology and Health Care–Associated Costs

Hand ◽

10.1177/1558944719866884 ◽

2019 ◽

pp. 155894471986688 ◽

Cited By ~ 1

Author(s):

Alfred Lee ◽

David L. Colen ◽

Justin P. Fox ◽

Benjamin Chang ◽

Ines C. Lin

Keyword(s):

United States ◽

Health Care ◽

Emergency Department ◽

Upper Extremity ◽

Emergency Departments ◽

Age Groups ◽

The United States ◽

Primary Diagnosis ◽

Trauma Patients ◽

Extremity Injuries

Background: Upper extremity injuries represent one of the most common pediatric conditions presenting to emergency departments (EDs) in the United States. We aim to describe the epidemiology, trends, and costs of pediatric patients who present to US EDs with upper extremity injuries. Methods: Using the National Emergency Department Sample, we identified all ED encounters by patients aged <18 years associated with a primary diagnosis involving the upper extremity from 2008 to 2012. Patients were divided into 4 groups by age (≤5 years, 6-9 years, 10-13 years, and 14-17 years) and a trauma subgroup. Primary outcomes were prevalence, etiology, and associated charges. Results: In total, 11.7 million ED encounters were identified, and 89.8% had a primary diagnosis involving the upper extremity. Fracture was the most common injury type (28.2%). Dislocations were common in the youngest group (17.7%) but rare in the other 3 (range = 0.8%-1.6%). There were 73.2% of trauma-related visits, most commonly due to falls (29.9%); 96.9% of trauma patients were discharged home from the ED. There were bimodal peaks of incidence in the spring and fall and a nadir in the winter. Emergency department charges of $21.2 billion were generated during the 4 years studied. While volume of visits decreased during the study, associated charges rose by 1.21%. Conclusions: Pediatric upper extremity injuries place burden on the economy of the US health care system. Types of injuries and anticipated payers vary among age groups, and while total yearly visits have decreased over the study period, the average cost of visits has risen.

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