Incidence, severity, and time loss associated with collegiate football fractures, 2004-2005 to 2013-2014

Cairns, Mark A.; Hasty, Eddie K.; Herzog, Mackenzie M.; Ostrum, Robert F.; Kerr, Zachary Y.

Affiliations

¹University of North Carolina Health Care, Chapel Hill, North Carolina, USA

²Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA

³Department of Exercise Science, University of North Carolina, Chapel Hill, North Carolina, USA

Abstract and keywords

Background: The inherent risk of any time loss from physical injury in 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.

Keywords: NCAA football; NCAA fractures; fractures; return to play

Links

DOI: 10.1177/0363546517749914

PubMed: 29377710

Cited Works (7)

Year	Entry
2012	Dragoo JL, Braun HJ, Durham JL, Chen MR, Harris AHS. Incidence and risk factors for injuries to the anterior cruciate ligament in National Collegiate Athletic Association football: data from the 2004-2005 through 2008-2009 National Collegiate Athletic Association injury surveillance system. Am J Sports Med. May 2012;40(5):990-995.
2015	Lievers WB, Adamic PF. Incidence and severity of foot and ankle injuries in men’s collegiate American football. Orthop J Sports Med. 2015;3(5):2325967115581593.
1999	Powell JW, Barber-Foss KD. Injury patterns in selected high school sports: a review of the 1995–1997 seasons. J Athl Train. September 1999;34(3):277-284.
2014	Kerr ZY, Dompier TP, Snook EM, Marshall SW, Klossner D, Hainline B, Corlette J. National Collegiate Athletic Association Injury Surveillance System: review of methods for 2004–2005 through 2013–2014 data collection. J Athl Train. July–August 2014;49(4):552-560.
2011	Kaplan LD, Jost PW, Honkamp N, Norwig J, West R, Bradley JP. Incidence and variance of foot and ankle injuries in elite college football players. Am J Orthop (Belle Meade, NJ). January 2011;40(1):40-44.
2007	Shankar PR, Fields SK, Collins CL, Dick RW, Comstock RD. Epidemiology of high school and collegiate football injuries in the United States, 2005-2006. Am J Sports Med. 2007;35(8):1295-1303.
2013	Hunt KJ, George E, Harris AHS, Dragoo JL. Epidemiology of syndesmosis injuries in intercollegiate football: incidence and risk factors from National Collegiate Athletic Association injury surveillance system data from 2004-2005 to 2008-2009. Clin J Sport Med. 2013;23(4):278-282.