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How COVID-19 Increased Fractures Among Adolescent Ice Hockey Players-A National Database Analysis From 2014 to 2023
Steiv Shore1, Alexis Neal1, Jordan Lubell1
1A.T. Still University Kirksville College of Osteopathic Medicine, Kirksville, MO,USA.
Background:
Ice hockey remains popular among adolescents aged 10-19, but limited research exists on how COVID-19 pandemic influenced injury rates in this group. Since pandemic disrupted youth sports through widespread shutdowns and changes in training environments, examining shifts in injury patterns particularly fractures is essential.
Hypothesis:
Fracture counts declined in 2020 due to reduced sports participation during pandemic but increased in 2021 as athletes returned to more intense gameplay, often with poorer conditioning and elevated psychological stress.
Study Design:
Retrospective cohort study, level 3.
Methods:
The study utilized the National Electronic Injury Surveillance System to evaluate emergency department visits for ice hockey-related injuries in adolescents (10-19 y) from 2014 to 2023. The focus was on fractures, and only ice hockey-specific injuries were included. Statistical analysis assessed annual injury trends.
Results:
A total of 3626 injuries were reported. Fractures were the most common diagnosis overall (22.1% of all injuries). The top 3 diagnoses were fractures, contusions (15.9%), and concussions (12.2%). Of note, fracture diagnosis revealed a decline during 2020, followed by a statistically significant increase by 2021, accounting for 30% of all reported injuries (P < .05) remained significant even after excluding 2020 data).
Conclusion:
Reduced activity likely caused the 2020 fracture decline. Although causation cannot be definitively established from National Electronic Injury Surveillance System data alone, this correlation may reflect reduced participation in 2020 and subsequent changes in training, conditioning, gameplay intensity, and possibly equipment quality upon return to sport.
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