Hand and wrist injuries are common in all sports. The types of injuries range from
traumatic fractures, which are most often seen in contact sports, such as football
and hockey, to stress and overuse injuries seen in gymnastics, racquet sports, and
golf.
Although the exact incidence of hand and wrist injuries in different sports is difficult
to assess accurately, the literature is replete with studies indicating certain trends
in several sports.
It is of note that hand and wrist injuries are more common in adolescents than in
adults. Over a 10-year period, the Cleveland Clinic found that 14.8% of athletic participants
under the age of 16 years sustained upper extremity injuries. Of these, 16% involved
the hand, whereas 9% involved the wrist.
1
The overall incidence of hand and wrist injuries in sports has been studied by Bergfeld
and colleagues at the Cleveland Clinic,
1
Dehaven and Lintner at the University of Rochester Sports Medicine Department,
5
and Rettig and associates at Methodist Sports Medicine Center in Indianapolis.
21
In the Cleveland Clinic study, a series of 113 hand and wrist injuries were examined.
Ninety-seven of the injuries occurred in football, 6 in soccer, 3 in wrestling, 3
in baseball, 2 in basketball, 1 in ice hockey, and 1 in rugby. The study reported
96 fractures, 13 sprains, and 4 dislocations. Metacarpal fractures accounted for 38
of the 96 fractures reported. There were 12 distal radius fractures and 11 scaphoid
fractures in the series. The study reported 27 thumb injuries including 12 ulnar collateral
ligament tears and 10 proximal phalangeal fractures. The Cleveland Clinic study primarily
reflects a football population and is consistent with other studies of injuries in
football.
Dehaven and Lintner
5
reported on data from 3431 cases reported at the University of Rochester Sports Medicine
Center. They noted that hand injuries constituted 5%, or 171, of all patients treated.
They reported 102 fractures, which represented 60% of all hand injuries. There were
72 phalangeal fractures, 27 metacarpal fractures, 2 carpal fractures, and 7 fracture
dislocations.Rettig and colleagues
21
reported on a 1-year survey of all hand injuries at the Methodist Sports Medicine
Center in Indianapolis. They noted that 213 injuries were seen in 207 people. This
represented 3% of the total number of new patients seen at the Center over this period
of time. Injuries included 125 fractures, 13 dislocations, and 45 sprains. Eighty
percent of the injuries occurred in males.Eight sports were selected for study with regard to the quantity and type of injury
and compared with the incidence in the overall group. Fractures accounted for 55%
of the injuries in these eight sports. Sprains accounted for 21%, whereas dislocations
accounted for 7%. Amount of time lost from sport was calculated and averaged 16.7
days with a range of 0 to 84 days.
It was noted that football accounted for the highest number of injuries as well as
the highest number of fractures (52%), dislocations (61%), and sprains (38%). Basketball
injuries included fractures (32%), dislocations (15%), and sprains (25%).
The situation in which the injury occurred also was studied, that is, practice, competition,
or recreational competition. It was noted that 28% of the injuries occurred in practice,
41% in competition, and 15.8% in recreational competition.
Another study that evaluated the incidence of hand and wrist injuries was reported
by Rettig and associates.
21
In this particular study, all of the injuries at the Olympic Training Center in Colorado
Springs, CO, over a 10-year period were reported. Of the 8311 injuries reported, 729
of the injuries were to the hand or wrist, which represented 8.7% of all reported
injuries. The injuries to the hand or wrist were reported in 36 sports and represented
731,000 athletic days. It is of note that football was not included in this study
because it is not an Olympic sport.A breakdown of the incidence per sport is as follows: roller hockey, 30%; baseball,
25%; boxing, 17%; basketball, 17%; volleyball, 13%; weight lifting, 13%; ice hockey,
12%; wrestling, 7%; and judo, 6%.
Sprains were the most common type of injury to the hand and wrist (49%), followed
by contusions (15%) and fractures (10%). It is of note that the Olympic Training Center
studied “grassroots” injuries, or those reported directly to the athletic trainer.
The prior studies were based on a referral population. Therefore, sprains and contusions
are the most common injuries seen in sports even though fractures are the most common
injuries seen at referral centers.
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Article info
Footnotes
Address reprint requests to Arthur C. Rettig, MD, Department of Education and Research, 1815 North Capitol Avenue, Suite 560, Indianapolis, IN 46202
Identification
Copyright
© 1998 W. B. Saunders Company. Published by Elsevier Inc. All rights reserved.
