Epidemiology of Lower Extremity Injuries among U.S. High School Athletes
Article first published online: 28 JUN 2008
Academic Emergency Medicine
Volume 14, Issue 7, pages 641–645, July 2007
How to Cite
Fernandez, W. G., Yard, E. E. and Comstock, R. D. (2007), Epidemiology of Lower Extremity Injuries among U.S. High School Athletes. Academic Emergency Medicine, 14: 641–645. doi: 10.1111/j.1553-2712.2007.tb01851.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Received January 25, 2007; revision March 9, 2007; accepted March 9, 2007
- high school sports
Objectives:Despite the health benefits of organized sports, high school athletes are at risk for lower extremity sports-related injuries (LESRIs). The authors documented the epidemiology of LESRIs among U.S. high school athletes.
Methods:Via two-stage sampling, 100 U.S. high schools were randomly selected. During the 2005 school year, LESRIs in nine sports were reported: boys' baseball, football, and wrestling; girls' softball and volleyball; and boys' and girls' basketball and soccer. The authors calculated rates as the ratio of LESRIs to the number of athlete exposures. National estimates were generated by assigning injuries a sample weight based on the inverse probability of the school's selection into the study.
Results:Among high school athletes in 2005, 2,298 of 4,350 injuries (52.8%) were LESRIs. This represents an estimated 807,222 LESRIs in U.S. high school athletes in nine sports (1.33/1,000 athlete exposures). Football had the highest LESRI rate for boys (2.01/1,000) and soccer the highest for girls (1.59/1,000). Leading diagnoses were sprains (50%), strains (17%), contusions (12%), and fractures (5%). The ankle (40%), knee (25%), and thigh (14%) were most frequently injured. Fractures occurred most often in the ankle (42%), lower leg (29%), or foot (18%). Girls with ligamentous knee injuries required surgery twice as often as boys (67% vs. 35%; p < 0.01). Girls had 1.5 times the proportion of season-ending LESRIs of boys (12.5% vs. 8%; p < 0.01).
Conclusions:While LESRIs occur commonly in high school athletes, team- and gender-specific patterns exist. Emergency department staff will likely encounter such injuries. To optimize prevention strategies, ongoing surveillance is needed.