11.361 sports injuries in a 15-year survey of a Level I emergency trauma department reveal different severe injury types in the 6 most common team sports

Abstract

Introduction Severe sports-related injuries are a common affliction treated in Level I trauma departments. Detailed knowledge on injury characteristics from different medical settings is essential to improve the development of injury prevention strategies in different team sports.

Methods Team sport injuries were retrospectively analysed in a Level I trauma department registry over 15 years. Injury and treatment data were compared with regard to competition and training exposure. Injury data such as “time of visitation”, “type of injury”, “multiple injured body regions” and “immediate hospitalisation” helped to define the severity level of each team sports injury.

Results At the Level I trauma department, 11.361 sports-related injuries were seen over 15 years, of which 34.0 % were sustained during team sports. Soccer injuries were the most common injuries of all team sports (71.4 %). The lower extremity was the most affected body region overall, followed by the upper extremity. Head injuries were mainly seen in Ice hockey and American football and concussion additionally frequently in team handball. Slight injuries like sprains or contusions occurred most frequently in all team sports. In soccer and team handball, injuries sustained in competition were significantly more severe (p < 0.001) than those sustained in practice.

Volleyball and basketball had a trend to higher rate of severe injuries sustained during practice sessions.

Conclusion Depending on the specific injury profile of each team sports, injury prevention strategies should address competitive as well as training situations, which

may need different strategies.

Zusammenfassung

Einleitung Schwere, sportbezogene Verletzungen werden häufig in Level-1-Traumazentren behandelt. Die Entwicklung besserer Strategien zur Verletzungsprävention in unterschiedlichen Teamsportarten erfordert detaillierte Kenntnisse der Verletzungscharakteristika aus verschiedenen medizinischen Bereichen.

Methoden Es erfolgte eine retrospektive Analyse der Teamsportverletzungen im Register eines Level-1-Traumazentrums über einen Zeitraum von 15 Jahren. Die Verletzungs- und Behandlungsdaten wurden im Hinblick auf die Wettkampf- und Trainingsexposition verglichen. Mithilfe verletzungsbezogener Daten wie Besuchszeitpunkt, Verletzungsart, Körperregionen mit multiplen Verletzungen und unmittelbare stationäre Aufnahme konnte der Schweregrad jeder Teamsportverletzung definiert werden.

Ergebnisse In diesem Level-I-Traumazentrum wurden in 15 Jahren 11 361 sportbezogene Verletzungen behandelt, von denen sich 34,0 % bei einem Teamsport ereigneten. Von allen Teamsportarten war die Verletzungsquote beim Fußball am höchsten (71,4 %). Die untere Extremität war die insgesamt am meisten betroffene Körperregion, gefolgt von der oberen Extremität. Kopfverletzungen wurden vorwiegend im Eishockey und American Football beobachtet, Gehirnerschütterungen darüber hinaus auch häufig im Handball. Bei allen Teamsportarten kam es am häufigsten zu leichten Verletzungen wie Verstauchungen oder Prellungen. Beim Fußball und Handball traten im Wettkampf deutlich schwerer ausgeprägte Verletzungen auf (p < 0,001) als während des Trainings. Beim Volleyball und Basketball zeigte sich tendenziell eine höhere Rate schwerer trainingsbedingter Verletzungen.

Schlussfolgerung In Abhängigkeit der speziellen Verletzungsprofile der einzelnen Teamsportarten sollten Strategien zur Verletzungsprävention sowohl auf Wettkampf- als auch auf Trainingssituationen ausgerichtet sein. Unter Umständen sind hier jeweils unterschiedliche Strategien erforderlich.

Key words

injury - team sports - football - emergency department - injury severity - injury prevention

Schlüsselwörter

Verletzung - Teamsportarten - Fußball - Notaufnahme - Schweregrad der Verletzung - Verletzungsprävention

• References

• 1 Feeley BT, Kennelly S, Barnes RP. et al. Epidemiology of national football league training camp injuries from 1998 to 2007. Am J Sports Med 2008; 36: 1596-1603
• 2 Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train 2007; 42: 311-319
• 3 Junge A, Langevoort G, Pipe A. et al. Injuries in team sport tournaments during the 2004 Olympic games. Am J Sports Med 2006; 34: 565-576
• 4 Soligard T, Myklebust G, Steffen K. et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ 2008; DOI: 10.1136/bmj.a2469.
• 5 Kluegl M, Shrier I, McBain K. et al. The prevention of sport injury: an analysis of 12,000 published manuscripts. Clin J Sport Med 2010; 20: 407-412
• 6 Mandelbaum BR, Silvers HJ, Watanabe DS. et al. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. Am J Sports Med 2005; 33: 1003-1010
• 7 Petersen W, Braun C, Bock W. et al. A controlled prospective case control study of a prevention training program in female team handball players: the German experience. Arch Orthop Trauma Surg 2005; 125: 614-621
• 8 Koch M, Zellner J, Berner A. et al. Influence of preparation and football skill level on injury incidence during an amateur football tournament. Arch Orthop Trauma Surg 2016; 136: 353-360
• 9 Krutsch W, Zeman F, Zellner J. et al. Increase in ACL and PCL injuries after implementation of a new professional football league. Knee Surg Sports Traumatol Arthrosc DOI: 10.1007/s00167-014-3357-y.
• 10 Alentorn-Geli E, Myer GD, Silvers HJ. et al. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors. Knee Surg Sports Traumatol Arthrosc 2009; 17: 705-729
• 11 McLean SG. The ACL injury enigma: we can’t prevent what we don’t understand. J Athl Train 2008; 43: 538-540
• 12 Adam AL, Schiff MA. Childhood soccer injuries treated in U. S. emergency departments. Acad Emerg Med 2006; 13: 571-574
• 13 Finch C, Valuri G, Ozanne-Smith J. Sport and active recreation injuries in Australia: evidence from emergency department presentations. Br J Sports Med 1998; 32: 220-225
• 14 De Loes M, Goldie I. Incidence rate of injuries during sport activity and physical exercise in a rural Swedish municipality: incidence rates in 17 sports. Int J Sports Med 1988; 9: 461-467
• 15 Fong DTP, Man CY, Yung PSH. et al. Sports-related ankle injuries attending an accident and emergency department. Injury, Int J Care Injured 2008; 39: 1222-1227
• 16 Leininger RE, Knox CL, Comstock RD. Epidemiology of 1.6 million pediatric soccer-related injuries presenting to US emergency departments from 1990 to 2003. Am J Sports Med 2007; 35: 288-293
• 17 Yard EE, Comstock RD. Injuries sustained by pediatric Ice hockey, Lacrosse, and field hockey athletes presenting to United States emergency departments, 1990–2003. J Athletic Train 2006; 41: 441-449
• 18 Fuller CW, Ekstrand J, Junge A. et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Br J Sports Med 2006; 40: 193-201
• 19 Diaz de leon-Miranda E, Redondo-Aquino G, Bueno-Olmos ME. et al. Associated factors to severe sport injuries. Rev Med Inst Mex Seguro Soc 2007; 45: 47-52
• 20 Kerr ZY, Collins CL, Pommering TL. et al. Dislocation/separation injuries among US high school athletes in 9 selected sports: 2005–2009. Clin J Sports Med 2011; 21: 101-108
• 21 Williams JM, Wright P, Currie CE. et al. Sports related injuries in Scottish adolescents aged 11–15. Br J Sports Med 1998; 32: 291-296
• 22 Drawer S, Fuller CW. Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br J Sports Med 2001; 35: 402-408
• 23 Ekstrand J, Gillquist J. Soccer injuries and their mechanism: a prospective study. Med Sci Sports Exerc 1983; 15: 267-270
• 24 Darrow CJ, Collins CL, Yard EE. et al. Epidemiology of severe injuries among United States high school athletes: 2005–2007. Am J Sports Med 2009; 37: 1798-1805
• 25 Rechel JA, Yard EE, Comstock RD. An epidemiologic comparison of high school sports injuries sustained in practice and competition. J Athletics 2008; 43: 197-204
• 26 Ekstrand J, Nigg BM. Surface-related injuries in soccer. Sports Med 1989; 8: 56-62
• 27 Agel J, Harvey EJ. A 7-year review of men’s and women’s ice hockey injuries in the NCAA. Can J Surg 2010; 53: 319-323
• 28 Brophy RH, Wright RW, Powell JW. et al. Injuries to kickers in American football. The national football league experience. Am J Sports Med 2010; 38: 1166-1172