Pediatric Softball Injuries Presenting to Emergency Departments

This study sought to characterize the mechanisms of injury responsible for common softball-related injuries in recent years.

The National Electronic Injury Surveillance System database was queried for all pediatric softball-related injuries presenting to participating US emergency departments from 2010 to 2019. Patients were classified by age as children (7-12 years), adolescents (13-18 years), or young adults (19-21 years). The case narrative of each injury was used to establish the mechanism of injury: hit by bat, hit by ball, sliding into base, collision with another player, catching, running, and throwing. Statistical weights provided by the Consumer Product Safety Commission were used to produce national injury estimates.

There were an estimated 511,117 pediatric softball injuries presenting to the emergency department over the study period, with a mean patient age of 14.3 years (95% confidence interval [CI], 14.1-14.4 years). The head/neck was the most commonly affected body part, making up 30.2% of cases (95% CI, 28.2%-32.2%). Injuries to the head/neck were most often caused by being hit by the ball (78.4%; 95% CI, 76.4%-80.3%) and most commonly resulted in a superficial injury (36.9%), internal injury (22.2%), or concussion (16.3%). Foot/ankle injuries were most frequently caused by sliding into base (51.5%; 95% CI, 47.0%-55.2%) and typically resulted in a sprain/strain (65.5%). The most frequent causes of shoulder/elbow injuries were being hit by the ball (33.3%; 95% CI, 28.6%-38.3%) and throwing the ball (27.6%; 95% CI, 22.8%-32.9%). These resulted most frequently in a sprain or strain (39.5%), followed by a superficial injury (28.2%). The proportion of softball injuries affecting the shoulder and elbow and the lower extremities increased with athlete age, whereas the proportion of injuries affecting the remainder of the upper extremities decreased with athlete age.

Being hit by the ball was the most common mechanism of injury, especially in the head/neck region, and shoulder/elbow injuries increase with athlete age. Coaches and leagues may consider mandating helmets for infielders and pitch counts for pitchers, especially among adolescent athletes.