Purpose
Hand and wrist injuries are common among competitive athletes and can have a substantial
impact on playing time and future participation. The purpose of this study was to
provide epidemiological data from the National Collegiate Athletic Association Injury
Surveillance Program to correlate injury diagnosis with the need for surgery and time
loss.
Methods
Using the National Collegiate Athletic Association Injury Surveillance Program, this
retrospective study extracted data of hand and wrist injuries for all 25 National
Collegiate Athletic Association sports from the academic years 2004–2005 to 2013–2014.
The “severe” category was defined as injuries resulting in the following: (1) surgery,
(2) season-ending status, or (3) more than 30 days of playing time loss. The epidemiologic
data included injury rate per 100,000 athlete exposures (defined as 1 athlete participating
in 1 practice or competition) based on diagnoses and demographic information such
as sports and sex. We used a Poisson regression model to estimate the incidence rate
and 95% confidence interval.
Results
Overall, 4,851 hand injuries were identified, with an injury rate of 41.2 per 100,000
athlete exposures. The most common diagnoses were metacarpal or phalangeal fractures
(19.9%), lacerations or contusions (15.4%), and wrist sprains (14.7%). The surgical
rate was 9.6%, and the season-ending rate was 5.8%. Severe injuries occurred in 17.5%
of the hand and wrist injuries; within this subset, the most common diagnoses included
metacarpal or phalangeal fractures (43.8%), scaphoid fractures (12.8%), and thumb
ulnar collateral ligament tears (8.7%). Scaphoid fractures and metacarpal or phalangeal
fractures had the highest surgical rate and season-ending rate among all the injuries.
Conclusions
The injury rate of hand and wrist injuries is comparable with those of other common
sports injuries. Approximately one fifth of the injuries were considered severe, which
led to a high surgical rate, and these had a considerable impact on the athletes’
ability to finish the season.
Type of study/level of evidence
Outcome research level II.
Key words
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References
- Sports-related wrist and hand injuries: a review.J Orthop Surg Res. 2016; 11: 1-15
- Acute hand injuries in athletes.Phys Sportsmed. 2017; 45: 151-158
- Epidemiology of hand and wrist injuries in NCAA men’s football: 2009-2010 to 2013-2014.Orthop J Sports Med. 2019; 72325967119835375
- Athletic hand injuries in intercollegiate field hockey players.Med Sci Sports Exerc. 2008; 40: 2022-2026
- Thumb injuries in intercollegiate men’s lacrosse.Am J Sports Med. 2010; 38: 527-531
- Incidence and risk factors for injuries to the anterior cruciate ligament in National Collegiate Athletic Association football: data from the 2004-2005 through 2008-2009 National Collegiate Athletic Association Injury Surveillance System.Am J Sports Med. 2012; 40: 990-995
- Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies.J Am Acad Orthop Surg. 2000; 8: 141-150
- Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 2: a review of prevention programs aimed to modify risk factors and to reduce injury rates.Knee Surg Sports Traumatol Arthrosc. 2009; 17: 859-879
- Upper extremity injuries in the National Football League: part I: hand and digital injuries.Am J Sports Med. 2008; 36: 1938-1944
- Injuries to the collateral ligaments of the metacarpophalangeal joint of the thumb, including simultaneous combined thumb ulnar and radial collateral ligament injuries, in National Football League Athletes.Am J Sports Med. 2017; 45: 195-200
- Upper extremity injuries in the National Football League: part II: elbow, forearm, and wrist injuries.Am J Sports Med. 2008; 36: 1945-1952
- Epidemiology of football injuries in the National Collegiate Athletic Association, 2004-2005 to 2008-2009.Orthop J Sports Med. 2016; 42325967116664500
- Epidemiology of hamstring strains in 25 NCAA sports in the 2009-2010 to 2013-2014 academic years.Am J Sports Med. 2015; 43: 2671-2679
- Trajectory subtypes after injury and patient-centered outcomes.J Surg Res. 2016; 202: 103-110
- Resiliency and quality of life trajectories after injury.J Trauma Acute Care Surg. 2017; 82: 939-945
- Prevalence of musculoskeletal disorders at the NFL Combine—trends from 1987 to 2000.Med Sci Sports Exerc. 2007; 39: 22-27
- National collegiate athletic association injury surveillance system: review of methods for 2004-2005 through 2013-2014 data collection.J Athl Train. 2014; 49: 552-560
- Epidemiology of Achilles tendon injuries in collegiate level athletes in the United States.Int Orthop. 2020; 44: 585-594
- Statistical Methods for Rates and Proportions.3rd ed. John Wiley & Sons, Hoboken2003
- Regression Analysis of Count Data.2nd ed. Cambridge University Press, Cambridge1998
- Epidemiology of hip and groin injuries in collegiate athletes in the United States.Orthop J Sports Med. 2018; 62325967118771676
- Epidemiology of quadriceps strains in National Collegiate Athletic Association Athletes, 2009-2010 through 2014-2015.J Athl Train. 2017; 52: 474-481
- Hand and wrist injuries among US high school athletes: 2005/06-2015/16.Pediatrics. 2017; 140e20171255
- Clinical and radiologic outcomes after scaphoid fracture: injury and treatment patterns in National Football League combine athletes between 2009 and 2014.Arthroscopy. 2017; 33: 2154-2158
- Fixation of nondisplaced scaphoid fractures: making treatment cost effective. Prospective controlled trial.Arch Orthop Trauma Surg. 2007; 127: 39-46
- Opinions regarding the management of hand and wrist injuries in elite athletes.Orthopedics. 2013; 36: 815-819
- Internal fixation of acute stable scaphoid fractures in the athlete.Am J Sports Med. 1996; 24: 182-186
- Return to sport following scaphoid fractures: a systematic review and meta-analysis.World J Orthop. 2019; 10: 101-114
- Operative treatment of metacarpal and phalangeal fractures in athletes: early return to play.J Orthop Sci. 2014; 19: 729-736
- Increasing lower extremity injury rates across the 2009-2010 to 2014-2015 seasons of National Collegiate Athletic Association Football: an unintended consequence of the "targeting" rule used to prevent concussions?.Am J Sports Med. 2016; 44: 3230-3236
Article info
Publication history
Published online: December 08, 2021
Accepted:
October 27,
2021
Received:
June 7,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
