Hand injuries in sports – a retrospective analysis of 364 cases

doi:10.21203/rs.3.rs-23570/v2

Download PDF

Research article

Hand injuries in sports – a retrospective analysis of 364 cases

https://doi.org/10.21203/rs.3.rs-23570/v2

This work is licensed under a CC BY 4.0 License

Journal Publication

published 08 Dec, 2020

Read the published version in BMC Musculoskeletal Disorders →

You are reading this older preprint version

Read the latest preprint version →

Background: Hand injuries are common in sports and associated with high drop-out rates and costs.

Hence, efforts should strive for further risk prevention measures in order to increase safety in sports. This implies knowledge of sports injury risk profiles. So far, major surveillance programs exist mainly in Anglo-American countries, reflecting the specific concerns of sports in this part of the world. Data on sports injuries within Europe are scarce. As sports behavior appears to vary demographically, we hypothesised that risk injury profiles differ as well.

Methods: To assess, whether the described sports injuries of the hand, published internationally, are applicable to the German population, we performed a five-year retrospective, single-center analysis of sports-related hand injuries, using the data of the Enterprise Clinical Research Warehouse of the Hannover Medical School.

Results: Notable differences in comparison to other data were observed. Ball sports, cycling and equestrian sports caused most of the recorded hand injuries, which were predominantly fractures of the wrist and hand. Hand injuries in equestrian sports were associated with significantly higher operation and hospitalisation rates as well as a significantly longer inpatient treatment.

Conclusion: Risk profiles for sports-related hand injuries appear to differ not only age- and sex-dependent, but also geographically. National as well as European hand trauma registries as well as a broad registry participation are necessary in order to accurately assess these risk patterns in the European latitudes and hence reduce hand injuries and the sequelae.

Orthopedics

sport

sports-related

injury

injuries

trauma

hand

equestrian sports

The benefits of sports on physical and mental health are globally evident and recognised [1]. Regular physical activity improves social skill development and self-esteem in children while contributing strongly to psychological health and stress-compensation in adults and is associated with an enhanced quality of life in young and old [2-5].

However, the omnipresent risk of injury still accounts for the major drawback within the life of every athlete, in both professional and amateur sports [6]. Previous prevention measures, such as rule changes or the introduction of protective clothing, managed to increase safety in many sports [7-9]. Rule changes made by the Amateur International Boxing Association (AIBA) in 2013 for example, resulted in a substantial decrease of boxing-related upper extremity injuries between 2012 – 2016, shown most impressively in a decline of hand injuries by 33% [7, 10]. Nevertheless, sports injuries still occur with high incidences, showing varying risk profiles within the different types of sport [11, 12]. Injuries of the hand account for approximately 25% of all sports-related injuries [13-22]. Hence, the hand is at high risk for injury during sportive activities. Within the National Football League Scouting Combine from 2009 – 2015 the hand, with 33.5%, was among the top five of the affected body regions [22]. The dimension of direct and indirect costs of hand and wrist injuries goes along with a great economic burden of these trauma entities [43, 44, 46]. So far evidence of risk profiles in sports is mainly based on data from large surveillance programs of the Anglo-American region, including the USA [18, 22, 23], Canada [24] and Australia [25-27]. In order to investigate the most common sports injuries of the hand and wrist [21, 28] in a European population and to contribute to the establishment of sports injury risk profiles, the following epidemiological study, based on data of a large hand trauma center in northern Germany, was performed.

Sports-related hand injuries, treated at the Department of Plastic, Aesthetic, Hand and Reconstructive Surgery of the Hannover Medical School, a level I trauma center and an a FESSH (Federation of European Societies for Surgery of the Hand)-accredited Hand Trauma Center, were retrospectively reviewed from February 2013 to February 2018. Patients with a verified sports injury of the hand were included regardless of their sex or age. The study was approved by the Ethics Committee of the Hannover Medical School.

Variables

Due to the small number of cases in the individual sport groups, sports were assigned to different sport supergroups for further statistical analyses. Since there is no evidence-based sports classification available, sport supergroups were defined in the most reasonable way (ball sports played with an assistive device such as a bat, racquet or stick – collectively referred to as ”ball sports with a bat”, ball sports played without a bat, racquet or stick – collectively referred to as “ball sports without a bat”, “gymnastics”, “martial arts”, “climbing”, “outdoor sports”, “precision sports”, “cycling”, “equestrian sports”, “skating”, “water sports”, “winter sports” and “miscellaneous”) (Table 2). Equestrian sports were defined as injuries that occurred during horse riding itself, as well as the horse handling in course of equitation, such as leading the horse by the rein or bridling a horse.

All included cases were reviewed for the following variables: age (continuous), sex (categorical), sport and sport group (categorical), treatment type (categorical), hospitalisations (categorical), length of hospital stay (LOS) (continuous) as well as ICD-10-GM codes (categorial).

Data acquisition

Physician discharge letters and operation reports of the above named department were extracted by the Enterprise Clinical Research Warehouse (ECRDW) of the Hannover Medical School, which is comprising data of clinical routine (such as diagnoses, laboratory findings, text findings) of >2.3 million patients [29]. The relevant cohorts were identified using a specific keyword search (Additional file 1) as well as the ICD-10-GM codes (International Statistical Classification of Diseases and Related Health Problems 10th Revision German Modification) for hand injuries (Table 1). A keyword list with 147 different relevant terms (named entities) was used to identify equivalent entities in the medical documents (named entity recognition approach) [30], which resulted in a total of 1530 cases. All collected data were automatically exported from the ECRDW into Microsoft Excel spreadsheets. The medical reports of these cases have been extracted for further processing. Since ICD-10-GM codes and the keyword search were not sensitive enough to verify that hand injuries were actually sports-related, an additional manual screening for those indicators of each of the extracted medical reports was performed. Finally, 364 patients with an ICD-10-GM diagnosis for a hand injury and a sports-related injury aetiology could be included in the analysis (Fig. 1). By means of the unique patient identification number, we verified that no patient was counted more than once.

Statistical Analysis:

For statistical analysis the IBM SPSS Statistics program (Version 26, released 2019) was used. To assess the distribution of continuous data a Kolmogorov-Smirnov was performed. For the comparison of non-parametrically distributed data, the Mann-Whitney-U test was applied. In case of parametric distribution, the data were compared with the Student’s two-sided t-Test. Categorical variables were analysed with the Pearson’s chi-squared test.

A total of 364 hand injuries, caused by 42 different types of sport, were treated (Fig. 2, Table 2).

The sport leading to most of the hand injuries was cycling (n=101, 28%), followed by football (n=66, 18%) and equestrian sports (n=46, 13%). According to supergroup categorisation the majority of sports-related hand injuries occurred in “ball sports without a bat” (n=114, 31%), again followed by cycling (n=101, 28%) and equestrian sports (n=46, 13%) (Fig. 3).

Sex

Overall, males were affected more often than females (females n=118, 32%; males n=246, 68%). Significant sex-dependent differences were observed in equestrian sports and football. 84% (n=39) of the equestrian-related hand injuries affected the female study population (p<0.001). With 33% equestrian sports accounted for most of the female sports injuries of the hand. Significantly more male patients suffered hand injuries during ball sports without a bat (n=101, 89%; p<0.001), which is mainly due to the large part of football-associated injuries. Statistical analysis revealed no significant difference between patient’s sex and LOS nor between sex and the need for operation respectively (p=0.306; p=0.703).

Age

Half of the study population was aged between 19 and 45 years, with a mean patient age of 32 ± 17 years (range 3–89). There was no significant difference between the age of female and male patients (p=0.343). Patient’s age was further not correlated with the necessity of an inpatient or operative treatment (p=0.648; p=0.556 respectively). However, the analysis revealed significant differences between patient’s age distribution and sports groups (p=0.015). Ball sports without a bat, climbing and gymnastics affected significantly more younger people (p<0.001; p=0.044; p=0.015), while cycling-related hand injuries occurred significantly more often among the elderly study population (p<0.001).

Operation, Hospitalisation, LOS

218 (60%) patients received an operative treatment, while 166 patients (46%) were hospitalised due to sports-related hand injuries. 76% (n=35) of all equestrian-related hand injuries were treated operatively (p=0.017), while 63% (n=29) of these injuries required hospitalisation (p=0.011). The mean length of inpatient stay was 3.7 ± 4.47 days (range 1–27). Equestrian Sports led to a significantly longer LOS (Equestrian sports mean 3.2 ± 5.2 days vs. total study population mean 1.7 ± 3.5 days; p=0.003). There was only one case where a patient was hospitalised without receiving surgical therapy, as the patient refused operation during the course of treatment.

ICD-10-GM

According to the principal diagnoses codes, the most frequent injury type was “Fractures of the wrist and hand” S62.- (n=141, 39%), followed by “Open wounds of the wrist and hand” S61.- (n=86, 24%) and “Luxations, sprains and strains of joints and ligaments at the height of the wrist and hand” S63.- (n=62, 17%) (Fig. 4).

There was no significant difference between patient’s sex and injury type (ICD-10-GM diagnosis) (p=0.595). Fractures accounted for most hand injuries in ball sports without a bat (p=0.007; n=53, 47 %) and equestrian sports (n=15, 32.6%; p<0.001). Among the cycling cohort there was a trend towards more S61.- (n=34, 34%) and S62.- (n=35, 35%) injuries. 64% (n=9) of all amputation injuries of the hand and wrist (S68.-) occurred during equestrian sports, which is significantly more than in any other sports group (p<0.001).

Besides the proven health benefits, the risk of injury represents the major drawback of sportive activities. Injury risk profiles may parallel demographic patterns, as well as social trends [1, 31-33]. In opposite to the United States, where a vast majority of sports-related hand injuries occur during American football, gymnastics, wrestling and basketball [31], we identified cycling, football and equestrian sports as the major causes of hand injuries in our cohort. Most of the observed injuries occurred in males and within the first two age quartiles, which is in line with previous reports [4, 34]. Ball sports played without an assistive device, climbing and gymnastics were predominantly responsible for hand injuries in the younger population, while a shift towards more cycling-related hand injuries could be observed in the elderly population. Equitation-related hand injuries do not only represent one of the most common sports injuries in our analysis but were also associated with a significantly higher operation and hospitalisation rate. The need for an operative treatment is mostly due to the increased rate of fractures in this sub-cohort. Furthermore, this sub-cohort accounted for 9 out of a total of 14 traumatic finger amputations in this study population. These findings support our clinical notion that complex injury patterns are common in equitation sports. Interestingly, equestrian sports seem to be underrepresented in the current literature, thus these findings might well add relevant information for clinical practice. The 2018 German examination regulations in equestrian sports specify mandatory gloves only in dressage and horse driving sports [35]. Regarding the high incidences of trauma and their severity, a broadening of this rule to all disciplines in equestrian sports, on the basis of the current results, should be discussed.

According to previous studies men represent the greater risk group for sports injuries. These observations can be confirmed by the presented results, where men are affected more than twice as often as women. Younger people, representing the physically most active population group, are at highest risk for sports injuries. 50% of the study population was aged between 19 and 45 years. Participation of young individuals in organised sports and high-frequency trainings are of increasing popularity, especially in the western world [2, 20, 36]. Simultaneously, a rising competitiveness, in terms of force and speed, is observable. Sport is one of the main causes of injuries in adolescents [37], with an increased risk for complicated injuries and long-term damage [36]. However, risk profiles appear to be dynamic, depending on demographic and social trends. Taking into account rising life expectancy and increasing sports activities throughout one’s life in developed countries, an increased incidence of sports injuries among the elderly population has to be expected [31]. The dynamics of sports injury risk profiles raises the demand for injury prevention measures. This, however, requires knowledge of sport specific injury risks and injury patterns respectively.

An analysis of injuries occurring in German club sports from 1987 to 2012, without specification on the hand, showed high injury risks in ball sports such as football, handball, basketball or volleyball [38]. These data, however, did not comprise the non-organised leisure sports, such as cycling, which proves to be a major risk sport in our patient population. Further major epidemiologic and demographic surveys about sports injuries in Germany go back to the years 1986 and 1999, already indicating differences of injury-causing sport types between Germany and the USA. Previous national surveys, seeking to assess sports injuries in Germany, are rare and mainly based on questionnaires [39-41]. According to our knowledge, this is the first study analysing sports injuries specifically in the hand in the German population.

A clear limitation of this study is its single-center character. Although the Department of Plastic, Aesthetic, Hand and Reconstructive Surgery of the Hannover Medical School is a maximum care hospital in lower Saxony with a supraregional catchment area, as well as a FESSH-accredited hand trauma center, this data cannot be generalised to the country.

Due to the retrospective character of the study, no information about the injury mechanisms is available, while a proper ICD-10-GM coding by the treating physicians has to be assumed. Previous operations or re-operations in other hospitals were not reported in the current database and thus cannot be taken into account. As there is no coding for sports injuries available, we utilised an extensive keyword analysis for data collection. Although performed with great care, this approach bears the risk of missing cases of sports-related hand injuries.

These data represent the basic stage within the Translating Research into Injury Prevention Practice framework (TRIPP) [42]. This gradual injury prevention model comprises six stages, leading from injury surveillance up to the implementation of developed prevention measures, and should give researchers support in the successful establishment of injury prevention measures in sports. Given that, a comprehensive monitoring of sports injuries is crucially needed in order to successfully guide and promote injury prevention programs. Supplemental support in this intent can be provided by apps or user friendly computer tools, enabling broadly accessible surveillance participation [25, 26].

The high costs associated with hand and wrist injuries are underlining the economic importance of maximal safety in sports [43]. In addition, the financial burden of these injuries can reach great extent also at individual level. Drop-out rates as well as high direct costs, which might not be covered by insurances, increase the barrier to sports participation among the population [43, 44, 46]. While surveillance programs for road injuries or occupational injuries are already well-established, the only available tool for injury monitoring on a national as well as a European level is the EU Injury Database (EU IDB) [44, 45]. However, a little more than half of the EU member states are contributing to this database. The free accessible EU IDB recorded a total of 235 sports-related hand and wrist injuries for Germany in the year 2016 only, suggesting a significant missing of data [45]. Another obstacle is the difficulty of monitoring hospital discharges due to sports injuries. As hospital statistics are mainly based on the ICD codings, which do not include sports injuries, a reliable monitoring is almost impossible at the moment [44].

Risk profiles for sports-related hand injuries appear to differ not only age- and sex-dependent, but also geographically. Unlike the typical sports-related hand injury profiles in the United States of America, cycling, football and equestrian sports were responsible for most sports-related hand injuries in our German study cohort. In order to better assess these risk patterns at European level and subsequently reduce injury rates and the sequelae, accurate injury surveillance programs are necessary. This could be provided by national as well as European hand trauma registries, presuming a comprehensive registry participation.

ECRW	Enterprise Clinical Research Warehouse
EU IDB	EU Injury Database
ICD‑10‑GM	International Statistical Classification of Diseases and Related Health Problems 10^th Revision German Modification
LOS	Length of stay
TRIPP	Translating Research into Injury Prevention Practice framework

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Hannover Medical School (Nr. 7840 BO K 2018).

Consent for publication

All patients consented for the scientific evaluation of their anonymised data.

Availability of data and materials

The anonymised datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Competing interests

The authors declare that they have no competing interests.

Funding

There was no specific funding for this study.

Authors' contributions

VAS, AK and PMV conceived the idea for the study and PMV is leading the trial. VAS, AK, HL and PMV designed the study. VAS and HL extracted the data from patient files. VAS performed a manual data quality check. VAS and AK drafted the manuscript with input from HL and PMV. All authors read and approved the final manuscript.

Acknowledgements

None.

Somerset S, Hoare DJ. Barriers to voluntary participation in sport for children: a systematic review. BMC pediatrics. 2018;18:47.
Moeijes J, van Busschbach JT, Wieringa TH, Kone J, Bosscher RJ, Twisk JWR. Sports participation and health-related quality of life in children: results of a cross-sectional study. Health and quality of life outcomes. 2019;17:64.
Eime RM, Young JA, Harvey JT, Charity MJ, Payne WR, Activity P. A systematic review of the psychological and social benefits of participation in sport for children and adolescents: informing development of a conceptual model of health through sport. 2013;10:98.
Eime RM, Harvey JT, Charity MJ, Casey MM, Westerbeek H, Payne WR. Age profiles of sport participants. BMC sports science, medicine & rehabilitation. 2016;8:6-9.
Bize R, Johnson JA, Plotnikoff RC. Physical activity level and health-related quality of life in the general adult population: a systematic review. Preventive medicine. 2007;45:401-15.
van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports medicine (Auckland, NZ). 1992;14:82-99.
Lemme NJ, Ready L, Faria M, DeFroda SF, Gil JA, Owens BD. Epidemiology of boxing-related upper extremity injuries in the United States. The Physician and sportsmedicine. 2018;46:503-8.
Vriend I, Gouttebarge V, Finch CF, van Mechelen W, Verhagen EALM. Intervention Strategies Used in Sport Injury Prevention Studies: A Systematic Review Identifying Studies Applying the Haddon Matrix. Sports medicine (Auckland, NZ). 2017;47:2027-43.
Drury BT, Lehman TP, Rayan G. Hand and Wrist Injuries in Boxing and the Martial Arts. Hand clinics. 2017;33:97-106.
Davis P, Waldock R, Connorton A, Driver S, Anderson S. Comparison of amateur boxing before and after the 2013 rules change and the impact on boxers' safety. British journal of sports medicine. 2018;52:741-6.
Tirabassi J, Brou L, Khodaee M, Lefort R, Fields SK, Comstock RD. Epidemiology of High School Sports-Related Injuries Resulting in Medical Disqualification: 2005-2006 Through 2013-2014 Academic Years. The American journal of sports medicine. 2016;44:2925-32.
King D, Hume PA, Hardaker N, Cummins C, Gissane C, Clark T. Sports-related injuries in New Zealand: National Insurance (Accident Compensation Corporation) claims for five sporting codes from 2012 to 2016. British journal of sports medicine. 2018.
Kerr ZY, Cortes N, Ambegaonkar JP, Caswell AM, Prebble M, Romm K, et al. The Epidemiology of Injuries in Middle School Football, 2015-2017: The Advancing Healthcare Initiatives for Underserved Students Project. The American journal of sports medicine. 2019;47:933-41.
Hollander K, Wellmann K, Eulenburg CZ, Braumann KM, Junge A, Zech A. Epidemiology of injuries in outdoor and indoor hockey players over one season: a prospective cohort study. British journal of sports medicine. 2018;52:1091-6.
Mountjoy M, Miller J, Junge A. Analysis of water polo injuries during 8904 player matches at FINA World Championships and Olympic games to make the sport safer. British journal of sports medicine. 2019;53:25-31.
Robinson PG, Murray IR, Duckworth AD, Hawkes R, Glover D, Tilley NR, et al. Systematic review of musculoskeletal injuries in professional golfers. British journal of sports medicine. 2019;53:13-8.
Panagodage Perera NK, Kountouris A, Kemp JL, Joseph C, Finch CF. The incidence, prevalence, nature, severity and mechanisms of injury in elite female cricketers: A prospective cohort study. Journal of science and medicine in sport. 2019.
Bartels DW, Hevesi M, Wyles C, Macalena J, Kakar S, Krych AJ. Epidemiology of Hand and Wrist Injuries in NCAA Men's Football: 2009-2010 to 2013-2014. Orthopaedic journal of sports medicine. 2019;7:2325967119835375.
Haeberle HS, Navarro SM, Power EJ, Schickendantz MS, Farrow LD, Ramkumar PN. Prevalence and Epidemiology of Injuries Among Elite Cyclists in the Tour de France. Orthopaedic journal of sports medicine. 2018;6:2325967118793392.
Rosenbaum YA, Awan HM. Acute hand injuries in athletes. The Physician and sportsmedicine. 2017;45:151-8.
Avery DM, 3rd, Rodner CM, Edgar CM. Sports-related wrist and hand injuries: a review. Journal of orthopaedic surgery and research. 2016;11:99.
Beaulieu-Jones BR, Rossy WH, Sanchez G, Whalen JM, Lavery KP, McHale KJ, et al. Epidemiology of Injuries Identified at the NFL Scouting Combine and Their Impact on Performance in the National Football League: Evaluation of 2203 Athletes From 2009 to 2015. Orthopaedic journal of sports medicine. 2017;5:2325967117708744.
Johnson BK, Brou L, Fields SK, Erkenbeck AN, Comstock RD. Hand and Wrist Injuries Among US High School Athletes: 2005/06-2015/16. Pediatrics. 2017; doi: 10.1542/peds.2017-1255.
Fridman L, Fraser-Thomas JL, McFaull SR, Macpherson AK. Epidemiology of sports-related injuries in children and youth presenting to Canadian emergency departments from 2007-2010. BMC sports science, medicine & rehabilitation. 2013;5:30-31.
Soomro N, Chhaya M, Soomro M, Asif N, Saurman E, Lyle D, et al. Design, Development, and Evaluation of an Injury Surveillance App for Cricket: Protocol and Qualitative Study. JMIR Mhealth Uhealth. 2019;7:e10978-e.
Finch CF, Staines C. Guidance for sports injury surveillance: the 20-year influence of the Australian Sports Injury Data Dictionary. Inj Prev. 2018;24:372-80.
Horan JM, Mallonee S. Injury Surveillance. Epidemiologic Reviews. 2003;25:24-42.
Cockenpot E, Lefebvre G, Demondion X, Chantelot C, Cotten A. Imaging of Sports-related Hand and Wrist Injuries: Sports Imaging Series. Radiology. 2016;279:674-92.
Gerbel S, Laser H, Schönfeld N, Rassmann T, editors. The Hannover Medical School Enterprise Clinical Research Data Warehouse: 5 Years of Experience. International Conference on Data Integration in the Life Sciences; 2018: Springer.
Rabe E, Hertel S, Hoffmann B, Pannier F, Ko A, Berboth G, et al. 54. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie eV (GMDS). 2009.
Geissler WB, Burkett JL. Ligamentous sports injuries of the hand and wrist. Sports medicine and arthroscopy review. 2014;22:39-44.
Mathisen FKS, Kokko S, Tynjala J, Torsheim T, Wold B. Leisure-time physical activity and participation in organized sports: Changes from 1985 to 2014 in Finland and Norway. Scandinavian journal of medicine & science in sports. 2019;29:1232-42.
Hulteen RM, Smith JJ, Morgan PJ, Barnett LM, Hallal PC, Colyvas K, et al. Global participation in sport and leisure-time physical activities: A systematic review and meta-analysis. Preventive medicine. 2017;95:14-25.
Steinbruck K. [Epidemiology of sports injuries--25-year-analysis of sports orthopedic-traumatologic ambulatory care]. Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin. 1999;13:38-52.
Deutsche Reiterliche Vereinigung F. Leistungs-Prüfungs-Ordnung (LPO), Regelwerk für den deutschen Turniersport: Deutsche Reiterliche Vereinigung e.V. (FN) 2018.
Caine D, Purcell L, Maffulli N. The child and adolescent athlete: a review of three potentially serious injuries. BMC sports science, medicine & rehabilitation. 2014;6:22.
Emery CA. Injury prevention in paediatric sport-related injuries: a scientific approach. British journal of sports medicine. 2010;44:64-9.
Henke T, Luig P, Schulz D. [Sports injuries in German club sports, Aspects of epidemiology and prevention]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz. 2014;57:628-37.
Steinbrück K. Epidemiologie von Sportverletzungen15-Jahres-Analyse einer sportorthopädischen Ambulanz. Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin. 1987;1:2-12.
Schneider S, Seither B, Tonges S, Schmitt H. Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups. British journal of sports medicine. 2006;40:334-9.
Schneider S, Yamamoto S, Weidmann C, Bruhmann B. Sports injuries among adolescents: incidence, causes and consequences. Journal of paediatrics and child health. 2012;48:E183-9.
Finch C. A new framework for research leading to sports injury prevention. Journal of science and medicine in sport. 2006;9:3-9.
de Putter CE, Selles RW, Polinder S, Panneman MJ, Hovius SE, van Beeck EF. Economic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study. The Journal of bone and joint surgery American volume. 2012;94:e56.
Kisser R, Bauer RJARSB. The burden of sports injuries in the European Union. 2012.
Injuries DataBase Public Access [Available from: https://webgate.ec.europa.eu/idb/public-access/.], accessed March, 23rd 2020.
Robinson LS, Brown T, O'Brien L. Profile and cost of sport and exercise-related hand and wrist injuries with emergency department presentation. Journal of science and medicine in sport. 2020;23:683-9

Table 1: ICD-10-GM codes used in the data extraction process.

S60.	Superficial injury of the wrist and hand
S61.	Open wound of the wrist and hand
S62.	Fracture of the wrist and hand
S63.	Luxation, sprain and strain of joints and ligaments at height if the wrist and hand
S64.	Injury of nerves at height of the wrist and hand
S65.	Injury of blood vessels at height of the wrist and hand
S66.	Injury of muscles and tendons at height of the wrist and hand
S67.	Crushing injury of the wrist and hand
S68.	Traumatic amputation of the wrist and hand
S69.	Other not further specified injury of the wrist and hand

Table 2: Absolute (n) and relative (%) numbers of patients with hand injuries and the associated type of sport and sports super group respectively.

Sports group/sports	Numbers (%)
Ball sports without a bat	114 (31 %)
Football	64
Handball	24
Volleyball	14
Basketball	8
Rugby	2
American Football	2
Ball sports (not further specified)	1
Cycling	101 (28 %)
Equestrian sports	46 (13 %)
Winter sports	24 (7 %)
Skiing	12
Ice skating	8
Snowboarding	3
Tobogganing	1
Martial arts	21 (6 %)
Boxing	11
Martial arts	10
Ball sports with a bat	13 (4 %)
Hockey	4
Ice hockey	4
Tennis	3
Cricket	1
Squash	1
Precision sports	11 (3 %)
Skittles	6
Bowling	4
Darts	1
Skating	8 (2%)
Skateboarding	4
Inline Skating	4
Water sports	7 (2%)
Water Skiing	2
Sailing	1
Surfing	1
Rowing	1
Canoe Polo	1
Swimming	1
Climbing	7 (2%)
Gymnastics	5 (1 %)
Trampolining	2
Turning	1
Bench Press	1
Fitness Training	1
Miscellaneous	4 (1 %)
Archery	2
Ballet Dancing	1
School sports (not further specified)	1
Outdoor sports	3 (1%)
Hiking	1
Fishing	1
Jogging	1
Total	364 (100 %)

Additionalfile1.pdf

Download PDF

Journal Publication

published 08 Dec, 2020

Read the published version in BMC Musculoskeletal Disorders →

Editorial decision: Minor revision
11 Nov, 2020
Reviewer #1 agreed at journal
08 Oct, 2020
Reviewers invited by journal
05 Oct, 2020
Editor assigned by journal
29 Sep, 2020
Submission checks completed at journal
28 Sep, 2020
Editor invited by journal
28 Sep, 2020

You are reading this older preprint version

Read the latest preprint version →

Hand injuries in sports – a retrospective analysis of 364 cases

Status:

Journal Publication

Version 2

Abstract

Figures

Background

Methods

Results

Discussion

Conclusion

Abbreviations

Declarations

References

Tables

Supplementary Files

Status:

Journal Publication

Version 2