Trends in Sports-Related Upper Extremity Injuries Presenting to United States Emergency Departments: A Retrospective Analysis of National Injury Data

Background: Across many sports, injuries to the upper extremity (UE) are prevalent due to falls on an outstretched hand (FOOSH) and overuse. This retrospective analysis aimed to characterize sports-related UE injuries in the United States (US) over the past decade, examining injury frequency, affected body part, diagnosis, and hospital disposition across age, sex, and sport. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for sports injuries presented to US emergency departments (EDs) from 1 January 2014 to 31 December 2023. Patient demographics, injury site, diagnosis, and disposition were recorded. Annual injury trends were evaluated by linear regression. All statistical analysis was conducted using SPSS (version 30.0) software. Results: There were 1,330,108 nationally estimated (NE) UE sports injuries (47,371 NEISS Cases) that were presented to US EDs from 2014 to 2023. Linear regression revealed a significant decrease in annual injuries across the study period (β = −0.63, R² = 0.40 p = 0.05). For many sports, including football, basketball, soccer, baseball, softball, wrestling, volleyball, hockey, and rugby, rates of UE injury decreased significantly during the study period. Fractures were the predominant diagnosis across all age groups, observed among 99.3% of patients. Football was the most common sport associated with UE injury in elementary to high school-age children, with basketball becoming more common in patients from 19 to 50 years old. Tennis-related injuries were the most common for patients above 50 years old. Across all sports, the most commonly injured body parts were fingers (33.5%), wrists (20.3%), and lower arms (17.3%). Notably, shoulder injuries accounted for 99.1% of all wrestling cases and 71.5% of all lacrosse injuries included in this study. Conclusions: Sports-related UE injuries decreased significantly from 2014 to 2023, with notable declines during the COVID-19 pandemic. The injuries included in this study varied depending on sport, age, and sex, allowing for the recommendation of specific interventions. While few injuries led to hospitalization, those that did typically involved lower arm injuries; further efforts to reduce these injuries will reduce the burden placed on US hospitals.