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. 2023 Nov 10;11(11):23259671231188969.
doi: 10.1177/23259671231188969. eCollection 2023 Nov.

Management of Hand and Wrist Injuries in NCAA Division I Football Players From a Single Institution: Factors Associated With Epidemiology, Surgical Intervention, and Return to Play

Sofia Bougioukli  1 , Ioanna K Bolia  1 , Cory K Mayfield  1 , Luke T Nicholson  1 , Alexander E Weber  1 , Bryan S Bashrum  1 , Russell Romano  1 , James E Tibone  2 , Steven Shin  2 , Seth C Gamradt  1
Affiliations

Management of Hand and Wrist Injuries in NCAA Division I Football Players From a Single Institution: Factors Associated With Epidemiology, Surgical Intervention, and Return to Play

Sofia Bougioukli et al. Orthop J Sports Med. .

Abstract

Background: Upper extremity injuries account for approximately 16.9% of football injuries in the National Collegiate Athletic Association (NCAA).

Purpose: To determine the epidemiology, management, and outcomes of hand/wrist injuries in collegiate football athletes so as to identify factors associated with surgical intervention and delayed return to play (RTP).

Study design: Descriptive epidemiology study.

Methods: We retrospectively reviewed hand/wrist injuries that occurred within a single NCAA Division I football team from January 1, 2003, to December 31, 2020. Data analyzed included player position, college seniority, injury characteristics, injury management, surgical procedures performed, and timing of RTP. A univariate analysis was performed to identify factors associated with increased risk for surgical intervention and delayed (>21 days) RTP after hand and wrist injury in this cohort.

Results: Overall, 124 patients with 168 hand/wrist injuries were identified (9.9 wrist/hand injuries per year). Sprain of the thumb metacarpophalangeal (MCP) joint ulnar collateral ligament (UCL) was the most common diagnosis (19.6%). Surgery was required in 22% of injuries, with injury of the UCL of the thumb MCP joint (8/37) being the most common indication. Injuries occurring during competitive games (odds ratio = 4.29; 95% CI, 1.2-15.9) were associated with an increased risk for surgery. Most (70%) injuries did not lead to time missed from football, whereas the remaining 30% resulted in an average of 33 ± 36 days missed.

Conclusion: Over 17 athletic seasons, the annual incidence of hand and wrist injury in these NCAA Division I football players was 9.9 injuries per year, with 22% requiring surgical treatment. Injury to the UCL of the thumb MCP joint was the most common injury and indication for surgery, and 30% of injuries resulted in approximately 1 month lost. Injuries sustained in games were associated with operative management and delayed RTP.

Keywords: NCAA football; hand/upper extremity injuries; return to play; sports injury epidemiology.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: L.T.N. has received education payments from Micromed and hospitality payments from Axogen. A.E.W. has received education payments from Arthrex, consulting fees from Stryker; and nonconsulting fees from Arthrex. J.E.T. has received nonconsulting fees from Arthrex and hospitality payments from Stryker. S.S. has received education payments, consulting fees, nonconsulting fees, and royalties from Arthrex. S.C.G. has received consulting fees from Exactech and Zimmer Biomet, nonconsulting fees from Arthrex, and royalties from Zimmer Biomet. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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