Bartels, Douglas W.

Objectives: Participation in National Collegiate Athletic Association (NCAA) football is at an all-time high. This population experiences a substantial injury burden with many of these injuries affecting the upper extremities. The NCAA has adopted a data-driven decision-making process when providing recommendations for protecting player safety. The purpose of this study was to describe the epidemiology of hand and wrist injury in NCAA football in an effort to provide meaningful data for tailoring effective injury prevention strategies. Methods: An epidemiologic study utilizing the NCAA Injury Surveillance Program (NCAA-ISP) database was performed to investigate rates and patterns of hand and wrist injury in NCAA varsity football teams participating in the NCAA-ISP from 2009 to 2014. Descriptive statistics were used to present demographic data. Injury rates were calculated per 1000 athlete-exposures (AEs) using statistical cross-referencing between injury-level and event-level data. Injury mechanism and severity, as measured by time-loss from play, were determined and compared between exposure factors such as player position, player seniority, and practice versus game setting. Results: 725 hand and wrist injuries were captured in 899,225 AEs. The observed practice hand and wrist injury rate was 0.51 injuries per thousand AEs, which was significantly lower than the game injury rate of 3.60 (p < 0.01). Comparing player demographics for injuries sustained during practice as opposed to game time revealed significant differences based on player year, player position, activity performed at the time of injury, and mechanism of injury (p < 0.01, Figure 1). Player-on-player contact was the most common injury mechanism reported with blocking being the most common activity at injury. Of all sustained injuries, 71.4% resulted in no time loss from competition whereas 9.8% of injuries resulted in greater than 7 days of time loss. On average, fracture resulted in the greatest time loss from competition (8.3 ± 24.0 days for injuries sustained in practice setting, 7.7 ±15.8 days for injuries sustained in game setting). When comparing injury by location, hand injury resulted in greater time loss (3.7 ± 15.1, 4.4 ± 13.8) than to nail/subungual (0±0, 0±0), finger (1.6 ± 6.7, 1.1 ± 4.2), and wrist injury (1.2 ± 3.8, 1.8 ± 4.9). Conclusion: This study characterizes the incidence of NCAA football hand and wrist injuries in both practice and game settings and demonstrates the relatively low rate of injuries leading to loss of playing time. Hand and wrist injury was found to be significantly more common in games when compared to practice. Offensive linemen were the most commonly affected players in the cohort, with most injuries occurring during game time compared to practice. This study provides valuable prognostic data regarding expected time loss from play on a per injury pattern basis. Further investigation on specific injury subtypes and expected time loss as a result of these injures would provide trainers, players, and coaches with useful information on an expected post-injury recovery and rehabilitation timeline. [Figure: see text]

Background: Participation in National Collegiate Athletic Association (NCAA) football is at an all-time high. This population of athletes experiences a substantial injury burden, with many injuries affecting the upper extremities. Purpose/Hypothesis: The purpose of this study was to describe the epidemiology of hand and wrist injuries in college football players from the academic years 2009–2010 to 2013–2014. We hypothesized that variables such as event type (practice vs game), mechanism of injury, and player position would have an effect on the injury incidence. Study Design: Descriptive epidemiological study. Methods: An epidemiological study utilizing the NCAA Injury Surveillance Program was performed to investigate rates and patterns of hand and wrist injuries in participating varsity football teams from 2009–2010 to 2013–2014. Results: A total of 725 hand and wrist injuries were captured in 899,225 athlete-exposures. The observed practice injury rate was 0.51 injuries per 1000 athlete-exposures, compared with a game injury rate of 3.60 ( P < .01). Player-on-player contact was the most common injury mechanism reported, with blocking being the most common activity at the time of injury. Offensive linemen were most likely to experience an injury. Of all injuries sustained, 71.4% resulted in no time loss from competition, whereas 9.8% of injuries resulted in longer than 7 days of time loss. A fracture resulted in the greatest time loss from competition (mean ± SD, 8.3 ± 24.0 days; median, 0 days [range, 0-148 days] for injuries sustained in a practice setting) (mean ± SD, 7.7 ± 15.8 days; median, 0 days [range, 0-87 days] for injuries sustained in a game setting). Conclusion: Hand and wrist injuries were found to be significantly more common in games when compared with practices. This study provides valuable prognostic data regarding expected time loss on a per-injury pattern basis. Further investigation on specific injury subtypes and expected time loss as a result of these injures would provide trainers, players, and coaches with useful information on an expected postinjury recovery and rehabilitation timeline.