Injuries sustained by pediatric ice hockey, lacrosse, and field hockey athletes presenting to United States emergency departments, 1990-2003

Abstract

Context: Ice hockey, lacrosse, and field hockey are increasingly popular sports among US youth athletes, but no authors to date have compared injuries in male and female pediatric (ages 2 through 18 years) participants.

Objective: To compare patterns of injury among pediatric ice hockey, lacrosse, and field hockey players.

Design: A descriptive analysis of all pediatric (ages 2 through 18 years) ice hockey, lacrosse, and field hockey injuries captured by the US Consumer Product Safety Commission's National Electronic Injury Surveillance System.

Setting: US Consumer Product Safety Commission's National Electronic Injury Surveillance System.

Patients or other participants: Children with ice hockey, lacrosse, or field hockey injuries presenting to emergency departments participating in the National Electronic Injury Surveillance System.

Main outcome measures(s): We reviewed all ice hockey, lacrosse, and field hockey injuries captured by the National Electronic Injury Surveillance System and categorized them by sex, age, injury site, and injury diagnosis.

Results: An estimated 321 237 pediatric participants in ice hockey, lacrosse, and field hockey presented to US emergency departments from 1990 through 2003. The injured were primarily male (74.4%) and aged 10 through 18 years (95.4%). Ice hockey accounted for more injuries (53.6%) than lacrosse (26.5%) or field hockey (19.9%). Children aged 2 through 9 years sustained twice the proportion of head and face injuries (53.1%) as children aged 10 through 18 years (23.2%) (incidence rate ratio [IRR] = 2.25, 95% confidence interval [CI] = 1.94 to 2.62). Males incurred a higher proportion of shoulder and upper arm injuries (14.1%) than females (3.1%) (IRR = 4.51, 95% CI = 3.07 to 6.62). The proportion of concussion was higher in ice hockey players (3.9%) than in field hockey players (1.4%) (IRR = 2.75, 95% CI = 1.17 to 6.46). Females in lacrosse had twice the proportion of facial injuries (20.9%) as males (10.5%) (IRR = 1.95, 95% CI = 1.46 to 2.60). In all sports, the ball or puck caused a greater proportion of face injuries in females than in males (IRR = 2.48, 95% CI = 2.03 to 3.05). Facial injuries from falls occurred in higher proportions in ice hockey players (10.6%) than in lacrosse (2.4%) (IRR = 4.32, 95% CI = 1.53 to 12.18) and field hockey (0.4%) players (IRR = 28.38, 95% CI = 6.71 to 120.01).

Conclusions: Pediatric ice hockey, lacrosse, and field hockey injuries differed by age and sport and, within each sport, by sex. An understanding of sport-specific patterns of injury should assist coaches and certified athletic trainers in developing targeted preventive interventions.

Figure 1. Pediatric ice hockey, lacrosse, and field hockey athletes with injuries presenting to emergency departments by sport, United States, 1990–2003. Calculated using statistical weights provided by the Consumer Product Safety Commission National Electronic Injury Surveillance System and US Census age group population estimates. The trends for male field hockey, female ice hockey, and female lacrosse players contain fewer than 25 cases in some years and, thus, may be unstable .

Figure 2. Injury sites of pediatric ice hockey, lacrosse, and field hockey athletes presenting to emergency departments by sport, United States, 1990–2003. Calculated using statistical weights provided by the Consumer Product Safety Commission National Electronic Injury Surveillance System. Population numbers represent national yearly estimates calculated via 3-year rolling averages .

Figure 3. Regions of pediatric athletes' ice hockey, lacrosse, and field hockey injuries in athletes presenting to emergency departments by sport and sex, United States, 1990–2003. A, Males, n = 17 109. B, Females, n = 5949. Calculated using statistical weights provided by the Consumer Product Safety Commission National Electronic Injury Surveillance System. Population numbers represent national yearly estimates calculated via 3-year rolling averages .

Figure 4. Diagnoses of pediatric athletes with ice hockey, lacrosse, and field hockey injuries presenting to emergency departments by sport and sex, United States, 1990–2003. A, Males, n = 17 109. B, Females, n = 5949. Calculated using statistical weights provided by the Consumer Product Safety Commission National Electronic Injury Surveillance System. Population numbers represent national yearly estimates calculated via 3-year rolling averages .

Figure 5. Mechanisms of pediatric athletes' ice hockey, lacrosse, and field hockey facial injuries in athletes presenting to emergency departments by sport and sex, United States, 1990–2003. A, Males, n = 2459. B, Females, n = 1214. Calculated using statistical weights provided by the Consumer Product Safety Commission National Electronic Injury Surveillance System. Population numbers represent national yearly estimates calculated via 3-year rolling averages .