The Epidemiology of Sports-Related Orbital Fractures in the United States.

Abstract

To characterize the epidemiologic features of sports-related orbital fractures in the United States, including incidence, demographic patterns, mechanisms of injury, and associated ocular injuries. Retrospective cohort study. Patients with sports-related facial fractures recorded in the National Electronic Injury Surveillance System (NEISS) database from 2014 through 2023. Patients were identified using NEISS body part and diagnosis codes, along with trauma narratives specific to orbital fractures. National estimates were calculated using NEISS statistical weights. Demographics, sport type, fracture location, and associated ocular injuries were evaluated using descriptive statistics. Incidence and national estimates of sports-related orbital fractures, demographic distribution, sport type, fracture site, and frequency of associated ocular injuries. A total of 1468 patients with sports-related orbital fractures were identified, corresponding to a national estimate of 49 765 patients (95% confidence interval, 47 219-52 311). The mean ± standard deviation age was 27.1 ± 19.0 years, with the highest frequency in the 10- to 19-year age group. Seventy-nine percent of patients were male. The most frequently implicated sports were baseball (28.6%), bicycling (23.1%), and softball (6.7%). The orbital floor was the most commonly fractured site (59.8%). Among 865 patients with secondary injury data from 2019 through 2023, 13.8% of patients sustained associated ocular or periocular injuries, including eyelid lacerations (17.6%), corneal abrasions (13.4%), and hyphema (9.2%). Sports-related orbital fractures remain a significant cause of facial trauma in the United States, particularly among male adolescents and young adults. Baseball and bicycling are leading contributors. The predominance of orbital floor fractures and the presence of associated ocular injuries underscore the need for improved preventive strategies, including the adoption of sport-specific protective eyewear and targeted safety policies to reduce the burden of these injuries. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.