The Delayed Presentation and Diagnosis of Youth Wrestling Injuries: A 20-Year Analysis of National Injury Data
William H Huffman1, Steven R Ayotte, Lori Jia
1From the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA (Mr. Huffman, Mr. Ayotte, and Ms. Jia); the Department of Orthopaedic Surgery, Yale-New Haven Hospital, New Haven, CT (Dr. Pirruccio); the Department of Orthopaedic Surgery, Boston University Medical Center, Boston, MA (Dr. Li); the Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA (Dr. Kelly IV); and the Department of Orthopaedic Surgery, Mount Sinai, New York, NY (Dr. Parisien).
Introduction:
The nature of wrestling may lead athletes to mask injuries with the delayed presentations of youth wrestling-related injuries not being well characterized.
Methods:
This descriptive epidemiological study queried the National Electronic Injury Surveillance System database to characterize delayed presentations of wrestling-related injuries in middle and high-school athletes. Data collection consisted of national estimates, demographics, and injury characteristics of patients with delayed (D) presentations (≥1 day) and same-day (S) presentations to US emergency departments after sustaining a wrestling-related injury during the scholastic wrestling season (December to February, 2000 to 2019).
Results:
Of middle and high-school wrestlers presenting to US emergency departments, 5.6% (95% confidence interval [CI] 4.3% to 7.1%) reported delayed presentations for a total of 1,110 patients (CI, 591 to 1,630) annually. Most commonly (P < 0.001), injuries were sustained on Saturdays in both cohorts (D, 28.2%; CI, 22.4% to 34.8%; S, 29.6%; CI, 24.3% to 35.5%). Patients reporting delayed presentations were less likely to sustain fractures (D, 11.5%; CI, 8.3% to 15.6%; S, 18.9%; CI, 15.0% to 23.5%; P = 0.019) and injuries of the head/neck (D, 20.0%; CI, 16.5 to 24.1%; S, 26.2%; CI, 21.4% to 31.7%; P = 0.011).
Discussion:
A substantial proportion of adolescent wrestlers report delayed presentations of injuries. This emphasizes the need for vigilance in detecting subtle signs of injury.
