Youth and adolescent male ice hockey players at increased risk of fractures: a 20-year analysis of national injury data.

Abstract

Ice hockey is a high-impact sport that can put athletes in high-risk situations for injuries. While the game has shifted toward speed over physicality, fractures remain a major concern. Therefore, it would be valuable to observe whether this had an effect on fracture rates in men's ice hockey. The purpose of this study was to examine the frequency and trends of fractures sustained in men's ice hockey in the United States. All men's ice hockey-related fractures presented to United States EDs from 1 January 2004 to 31 December 2023 were queried using the National Electronic Injury Surveillance System (NEISS). For each fracture, patient disposition, demographics, and injury site were recorded. National estimates (NE) were calculated using the NEISS statistical sample weight. Injury trends were evaluated by linear regression modeling. A NE of 58,910 ice hockey-related fractures occurred among male players between 2004 and 2023. There was a qualitative decrease in annual fractures (<i>p</i> = 0.208) from 2004 to 2023. There was a significant decrease from 2004 to 2019 (<i>p</i> = 0.001) followed by a 172.6% increase to a record high number of fractures in 2022 (NE = 3,953). The hand was the most commonly fractured part of the body (NE = 17,400, 29.5%). All body regions, except the leg, saw increases in annual injury frequency, including record highs for head, trunk, and shoulder fractures. Adolescents (ages 13-19 years) had the highest fracture rates (56.6%) amongst age groups. Fracture hospitalization rate was 5.5% overall (NE = 3,264). While the overall number of fractures amongst male ice hockey players decreased yearly until the COVID-19 pandemic, a sharp increase in fractures was observed, reaching a record high in 2022. Additionally, the hand was the most commonly fractured part of the body, and adolescents have the highest risk of fractures from ice hockey.