Citation

Cairns MA, Hasty EK, Herzog MM, Ostrum RF, Kerr ZY. Am. J. Sports Med. 2018; 46(4): 987-994.

Affiliation

Department of Exercise Science, University of North Carolina, Chapel Hill, North Carolina, USA.

Copyright

(Copyright © 2018, American Orthopaedic Society for Sports Medicine, Publisher SAGE Publishing)

DOI

10.1177/0363546517749914

PMID

29377710

Abstract

BACKGROUND: The inherent risk of any time loss from physical injury in American football has been extensively discussed, with many such injuries having a profound effect on the lives of National Collegiate Athletic Association (NCAA) football players. However, the incidence of fractures in collegiate football has not been well established.

PURPOSE: To examine the epidemiology of fractures in NCAA football. STUDY DESIGN: Descriptive epidemiology study.

METHODS: Fracture data reported in college football during the 2004-2005 to 2013-2014 academic years were analyzed from the NCAA Injury Surveillance Program (NCAA-ISP). Fracture rates per 1000 athlete-exposures, surgery and time loss distributions, injury rate ratios, injury proportion ratios (IPRs), and 95% CIs were reported.

RESULTS: Overall, 986 fractures were reported. The rate of competition fractures was larger than the rate of practice fractures (1.80 vs 0.17 per 1000 athlete-exposures; injury rate ratio = 10.56; 95% CI, 9.32-11.96). Fractures of the hand/fingers represented 34.6% of all injuries, while fibula fractures (17.2%) were also common. A majority (62.5%) of all fractures resulted in time loss >21 days. Altogether, 34.4% of all fractures required surgery, and 6.3% were recurrent. The proportion of fractures resulting in time loss >21 days was higher for fractures requiring surgery than fractures not requiring surgery (85.0% vs 50.7%; IPR = 1.68; 95% CI, 1.53-1.83). The proportion of recurrent and nonrecurrent fractures requiring surgery did not differ (35.5% vs 34.3%; IPR = 1.03; 95% CI, 0.73-1.46); however, recurrent fractures were more likely to require surgery than nonrecurrent fractures when restricted to the hand/fingers (66.7% vs 27.2%; IPR = 2.45; 95% CI, 1.36-4.44).

CONCLUSION: Fractures in collegiate football were sustained at a higher rate in competition than practice and frequently required extended time lost from participation, particularly among those requiring surgery. Prevention strategies are warranted to reduce incidence and severity of fractures.

Language: en

Keywords

NCAA football; NCAA fractures; fractures; return to play