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Published on: March 12, 2021
Post-covid changes in the epidemiology of pediatric shoulder dislocations: A 10-year national database analysis
Matthew S Miyasaka1, Auston R Locke1, Niklas H Koehne1
1Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Insights
Pediatric shoulder dislocations decreased in football and basketball for males. However, female shoulder injuries rose post-pandemic, suggesting a higher risk of inactivity-related injuries in girls.
Area of Science:
- Orthopedics
- Sports Medicine
- Epidemiology
Background:
- Previous research linked COVID-19 pandemic inactivity to increased post-pandemic injuries.
- This study investigates 10-year trends in pediatric shoulder dislocations in US emergency departments (EDs).
Purpose of the Study:
- To analyze trends in pediatric shoulder dislocations over a decade.
- To identify demographic and activity-related factors influencing these trends.
- To compare injury rates before, during, and after the COVID-19 pandemic.
Main Methods:
- Utilized the National Electronic Injury Surveillance System (NEISS) for data from 2014-2023.
- Calculated national estimates using NEISS statistical weights.
- Performed regression analyses to assess trends by gender, race, age, and activity.
Main Results:
- Identified 123,546 estimated pediatric shoulder dislocations.
- Males had disproportionately more dislocations than females.
- Decreased rates in football and basketball for all, especially males; increased rates in basketball and volleyball for females post-COVID.
- Atraumatic instability events in bed peaked during COVID.
Conclusions:
- Male shoulder dislocation rates in football and basketball declined.
- Female shoulder dislocations increased post-pandemic in basketball and volleyball.
- Findings suggest females may face a higher risk of inactivity-related injuries.
Background:
Previous studies have suggested that inactivity during the COVID-19 pandemic led to higher incidences of injury post-pandemic. This study aims to explore 10-year trends in pediatric shoulder dislocations presenting to United States emergency departments (EDs).
Methods:
The National Electronic Injury Surveillance System (NEISS) was queried for pediatric shoulder dislocations presenting to US EDs between January 1, 2014 and December 31, 2023. NEISS statistical weights were used to compute annual national estimates. A series of regression analyses were performed to measure annual trends stratified by gender, race, age, and activity. Finally, average incidence rates for the three most implicated activities for boys and girls were compared before, during, and after the COVID pandemic.
Results:
There were a total of 3724 pediatric shoulder dislocations reported in NEISS, representing a national estimate of 123,546 cases. Males sustained disproportionately more shoulder dislocations than females. Regression analyses revealed no significant trends for cohorts stratified by gender, race, or age, except for "Other/Mixed Race" whose annual rate decreased significantly (p < 0.01, β = -216.12). Shoulder dislocation rates for football (p < 0.05, β = -101.04) and basketball (p < 0.05, β = -109.82) also decreased significantly during the entire study period, and both activities maintained a decreasing trend for males post-Covid. For females, basketball and volleyball injury rates increased post-Covid, while atraumatic instability events in bed peaked during Covid.
Conclusions:
Sustained lower rates of shoulder dislocations were observed for males in both basketball and football. Meanwhile, female shoulder dislocations decreased during but increased after the pandemic in both basketball and volleyball. Our study suggests females may be at higher risk of inactivity-related injury.
Level Of Evidence:
Level IV; Cross sectional; Descriptive Epidemiology Study.
