Hand and Wrist Injuries Among Collegiate Athletes: The Role of Sex and Competition on Injury Rates and Severity

Abstract

Background: There is a high incidence of hand and wrist injuries in athletes participating in collegiate sports, but there is little information published characterizing them. Purpose: To characterize hand and wrist injuries in collegiate athletes using a large national database. Study Design: Descriptive epidemiology study. Methods: This retrospective cross-sectional analysis was designed using data from the National Collegiate Athletic Association (NCAA) Injury Surveillance Program database to identify hand and wrist injuries (exclusive of any radial or ulnar fractures) in male and female collegiate athletes participating in NCAA Division I, II, and III sports from 2004 to 2015. Descriptive analyses were performed on stratified data to examine the associations between these injuries and sport, event type, and sex. Results: Men’s ice hockey (8.25 per 10,000 athlete-exposures [AEs]) and women's ice hockey (8.21 per 10,000 AEs) had the highest rate of hand and wrist injuries in all exposures. In every sport except women’s gymnastics ( P = .107), injuries were more commonly sustained during competition rather than during practice. Ligamentous injury to the phalynx was the most commonly sustained injury overall (1.416 per 10,000 AEs), and a metacarpal fracture was the most commonly sustained hand or wrist fracture (0.507 per 10,000 AEs). Injuries sustained during men’s wrestling (14.08 days) and women’s gymnastics (10.39 days) incurred the most time lost from sport. Surgery for hand and wrist injuries was most commonly required for men’s football (0.413 per 10,000 AEs) and women’s field hockey (0.404 per 10,000 AEs). Conclusion: Hand and wrist injuries were common among collegiate athletes. Male athletes experienced injuries with more frequency and severity. Injuries occurred more commonly during competition. While the majority of injuries were minor and did not require surgery, certain sports conferred a much higher risk of significant injuries requiring a surgical intervention.

Management of Hand and Wrist Injuries in NCAA Division I Football Players From a Single Institution: Factors Associated With Epidemiology, Surgical Intervention, and Return to Play

“…Previous studies have reported the epidemiology of hand and wrist injuries in NCAA football players. 1,2,5,13 Bartels et al 1 reported the epidemiology of hand and wrist injuries in collegiate football players over 5 athletic seasons (2009-2010 to 2013-2014), using data from the NCAA ISP. The authors reported a significantly higher incidence rate of hand and wrist injuries during competitive matches compared with practice (3.6 vs 0.51 injuries per 1000 AEs, respectively) in football players competing in all 3 NCAA Divisions.…”

“…10,11,14,15 The majority of descriptive epidemiological studies analyzing hand and wrist injuries in collegiate football players use data from the NCAA ISP, which lacks clinical details including specific diagnoses, type, and duration of immobilization, and surgical procedures performed. 1,4,5,13 More detailed clinical data on the management and outcomes of hand and wrist injuries in collegiate football athletes are available mostly through small case series and case reports. 2,3,6,7,9,16,17 In addition, the risk factors for surgical intervention and those related to early or delayed time to return to play (RTP) have not been investigated.…”

Hand and wrist injuries among collegiate athletes vary with athlete division

“…Our recent publication studied the epidemiology of such injuries across major collegiate sports stratified by gender and competition. We revealed that male athletes experience injuries with more frequency and severity than female athletes and injuries were more likely to occur in competition than practice (Simpson et al 2020 ). Our results have been supported by other publications evaluating the epidemiology of varying injuries using the ISP (Dalton et al 2015 ; Fraser et al 2017 ; Kerr et al 2011 ; Zuckerman et al 2015 ).…”

“…This change in injury reporting was uniform across all divisions and genders, so this change should not affect the findings of the study. The two eras have been combined in similar analyses previously (Simpson et al 2020 ; Kerr et al 2014 ; Chorney et al 2017 ).…”

“…We recently published our analysis of hand and wrist injuries in collegiate athletes using the ISP, with specific focus on sport-specific rates of injury while stratifying by event type and gender. We demonstrated the highest hand and wrist injury rates were in men’s and women’s ice hockey, that men were more likely to sustain such injuries and more likely to miss time from their sport than their female counterparts (Simpson et al 2020 ). Our results supported the existing ISP-based literature, which also found similar discrepancies in injury rates between gender across different sports (Dalton et al 2015 ; Fraser et al 2017 ; Kerr et al 2011 ; Zuckerman et al 2015 ).…”