European A
soccer
injuries
prospective epidemiologic and socioeconomic study KRISTIAN HØY,* MD, BENT ERLING LINDBLAD, MD, CARSTEN JUHL TERKELSEN, MD, HAAKON EINAR HELLELAND, MD, AND CHRISTIAN JUHL TERKELSEN, MS From the
Department of Orthopedic Surgery,
Randers
City Hospital, Randers,
Denmark
ABSTRACT
MATERIALS AND METHODS
In 1 year, 715 patients with soccer injuries were registered and treated in the emergency department of Randers City Hospital. We did a prospective study of these patients using a questionnaire to determine the most common locations, types, mechanisms, and treatments of injury. Financial costs for society and the individual were also examined. Forty-nine percent of the injuries were to the joints; sprains and contusions were the most common types of injury, accounting for 46% and 25%, respectively. The majority of patients (64% of the men and 58% of the women) were injured during physical contact with another player. Most (63%) of the patients were treated in the emergency department and then released. Thirtyone percent had to be absent from work, but only 8% of the patients had a loss of income because of their injury. The average amount of work time lost was 5
We studied all players who presented to the emergency department of the Randers City Hospital, Denmark, with soccer-related injuries during a 1-year period (1980 to 1981). This hospital serves a well-defined geographic area with 124,321 inhabitants; it is a region that is a representative sample of the country. Free care is provided to all patients who come to the emergency department. There were 715 soccer injuries in 646 male and 69 female
patients. Soccer-related injury was defined as an occurrence that caused players to go to the hospital for treatment. These injuries made up 39% of the total number (1839) of sports injuries seen at this hospital during the study period. 4,8 During the year of the study, the total number of registered injuries in the emergency department was 17,700. The standard case record for each patient included the following: age, sex, time of trauma from start of game, type and anatomic location of injury [according to the World Health Organization (WHO) international classification], mechanism of injury, team affiliation, severity of injury, type of treatment, and the use of prophylactic equipment. Severity of the injury was defined according to the Abbreviated Injury Scale (AIS)12 and by the length of time absent from sport. In the AIS, injuries are graded according to severity: no injury, 0; minor, 1; moderate, 2; severe, 3. The mechanism of injury was investigated by asking the following questions: When did the injury happen, during training or warmup? Did the injury occur during tournament, recreational, or school soccer? Did the injury occur because the rules of the game were violated? Did the equipment, or lack of the same, such as shin guards or appropriate shoes, have any connection with the injury? Did any earlier injuries
days. Soccer is considered by many to be the most popular game all over the world and is played by at least 40 million people.16 Because of the vast number of soccer injuries seen in emergency departments, the traumatology and epidemiology of these injuries has become the object of major medical interest.4-9,~3 Therefore, we undertook a prospective investigation to describe these injuries, as well as their social and economic consequences. These problems have been addressed by other authors,’,&dquo; but most studies of soccer injuries have been based on specialized sports injury clinics or soccer clubs.1,6,lO,ll,14,17 The strength of this study is that it is population-based.
influence the current accident? Of the 715 patients, 584 (82%) agreed to a followup 1 to 4 years after the initial treatment. At this evaluation, the following information was recorded: time absent from sport; length of hospitalization, if any; time absent from work
*
Address correspondence and reprint requests to: Kristian Hoy, MD, Aarhus University Hospital, Department of Orthopedic Surgery, Tage Hansens Gade
2, DK-8000 Aarhus C, Denmark. 318
319
TABLE 2 Sex distribution according to AIS rating
because of injury; and economic consequences for the individual. All of the data were analyzed in a computer database. 18 Statistical analysis was performed using a chi-square test. To compare AIS ratings with the period absent from sport and length of hospitalization, we used Kendall’s tau C test. Coefficients of rank correlation and P-values are stated. Pvalues less than 0.05 were considered to be statistically
significant. TABLE 3
AIS rating compared to place of injury
RESULTS
According to the Danish Sports Association, the total number of registered active club players in the area is 6575 men and 658 women. The age and sex distribution of the players in this study is seen in Figure 1. There was an equal distribution among the three age groups who presented to the emergency department (Table 1). The ratio of men to women was 9:1, both among all active club players in the area and for the study group. The average age of the women in the study group was 19 years (range, 10 to 39) and the average age of the men was 22 years (range, 5 to 54). Ten percent of all injuries were found in women, and there was no significant difference in severity among the female soccer players compared to the male players, as seen in Table 2. By comparing the age distribution and AIS ratings, we
a P
0.02.
soccer
injuries
prospective epidemiologic and socioeconomic study KRISTIAN HØY,* MD, BENT ERLING LINDBLAD, MD, CARSTEN JUHL TERKELSEN, MD, HAAKON EINAR HELLELAND, MD, AND CHRISTIAN JUHL TERKELSEN, MS From the
Department of Orthopedic Surgery,
Randers
City Hospital, Randers,
Denmark
ABSTRACT
MATERIALS AND METHODS
In 1 year, 715 patients with soccer injuries were registered and treated in the emergency department of Randers City Hospital. We did a prospective study of these patients using a questionnaire to determine the most common locations, types, mechanisms, and treatments of injury. Financial costs for society and the individual were also examined. Forty-nine percent of the injuries were to the joints; sprains and contusions were the most common types of injury, accounting for 46% and 25%, respectively. The majority of patients (64% of the men and 58% of the women) were injured during physical contact with another player. Most (63%) of the patients were treated in the emergency department and then released. Thirtyone percent had to be absent from work, but only 8% of the patients had a loss of income because of their injury. The average amount of work time lost was 5
We studied all players who presented to the emergency department of the Randers City Hospital, Denmark, with soccer-related injuries during a 1-year period (1980 to 1981). This hospital serves a well-defined geographic area with 124,321 inhabitants; it is a region that is a representative sample of the country. Free care is provided to all patients who come to the emergency department. There were 715 soccer injuries in 646 male and 69 female
patients. Soccer-related injury was defined as an occurrence that caused players to go to the hospital for treatment. These injuries made up 39% of the total number (1839) of sports injuries seen at this hospital during the study period. 4,8 During the year of the study, the total number of registered injuries in the emergency department was 17,700. The standard case record for each patient included the following: age, sex, time of trauma from start of game, type and anatomic location of injury [according to the World Health Organization (WHO) international classification], mechanism of injury, team affiliation, severity of injury, type of treatment, and the use of prophylactic equipment. Severity of the injury was defined according to the Abbreviated Injury Scale (AIS)12 and by the length of time absent from sport. In the AIS, injuries are graded according to severity: no injury, 0; minor, 1; moderate, 2; severe, 3. The mechanism of injury was investigated by asking the following questions: When did the injury happen, during training or warmup? Did the injury occur during tournament, recreational, or school soccer? Did the injury occur because the rules of the game were violated? Did the equipment, or lack of the same, such as shin guards or appropriate shoes, have any connection with the injury? Did any earlier injuries
days. Soccer is considered by many to be the most popular game all over the world and is played by at least 40 million people.16 Because of the vast number of soccer injuries seen in emergency departments, the traumatology and epidemiology of these injuries has become the object of major medical interest.4-9,~3 Therefore, we undertook a prospective investigation to describe these injuries, as well as their social and economic consequences. These problems have been addressed by other authors,’,&dquo; but most studies of soccer injuries have been based on specialized sports injury clinics or soccer clubs.1,6,lO,ll,14,17 The strength of this study is that it is population-based.
influence the current accident? Of the 715 patients, 584 (82%) agreed to a followup 1 to 4 years after the initial treatment. At this evaluation, the following information was recorded: time absent from sport; length of hospitalization, if any; time absent from work
*
Address correspondence and reprint requests to: Kristian Hoy, MD, Aarhus University Hospital, Department of Orthopedic Surgery, Tage Hansens Gade
2, DK-8000 Aarhus C, Denmark. 318
319
TABLE 2 Sex distribution according to AIS rating
because of injury; and economic consequences for the individual. All of the data were analyzed in a computer database. 18 Statistical analysis was performed using a chi-square test. To compare AIS ratings with the period absent from sport and length of hospitalization, we used Kendall’s tau C test. Coefficients of rank correlation and P-values are stated. Pvalues less than 0.05 were considered to be statistically
significant. TABLE 3
AIS rating compared to place of injury
RESULTS
According to the Danish Sports Association, the total number of registered active club players in the area is 6575 men and 658 women. The age and sex distribution of the players in this study is seen in Figure 1. There was an equal distribution among the three age groups who presented to the emergency department (Table 1). The ratio of men to women was 9:1, both among all active club players in the area and for the study group. The average age of the women in the study group was 19 years (range, 10 to 39) and the average age of the men was 22 years (range, 5 to 54). Ten percent of all injuries were found in women, and there was no significant difference in severity among the female soccer players compared to the male players, as seen in Table 2. By comparing the age distribution and AIS ratings, we
a P
0.02.
