American football is the youth sporting activity most commonly associated with acute vertebral fractures

ABSTRACT

Objectives

Athletics confer cardiovascular fitness and improved cognitive processing in pediatric populations. However, one risk of sports participation is acute vertebral fracture, an injury with significant morbidity. It is currently unknown which sports represent the highest risk of acute vertebral fracture in pediatric populations. This study seeks to identify the youth sporting activities most commonly associated with acute vertebral fractures presenting to United States (U.S.) emergency departments (EDs).

Methods

This cross-sectional, retrospective study queries the National Electronic Injury Surveillance System database to report national weighted estimates and demographic characteristics of pediatric patients with acute vertebral fractures presenting to U.S. EDs.

Results

The mean annual incidence of estimated acute vertebral fractures over the study period was 1,672 (C.I. 1,217–2,126). From 2000–2001 (N = 4,030; C.I. 2,934–5,125) to 2016–2017 (N = 2,559; C.I. 1,681–3,438), there was no significant change in the estimated rate of sports-related acute vertebral fractures in pediatric patients (p = 0.09). American football was identified as the sport most frequently associated with acute vertebral fractures (23.4%; C.I. 17.6–29.3%). We found no appreciable change in the rate of football-related acute vertebral fractures over time, with 48.2% (C.I. 37.3–59.0%) occurring from 2000 to 2008 and 51.8% (C.I. 41.0–62.7%) from 2009 to 2017.

Conclusions

While sports-related acute vertebral fractures remain rare injuries in pediatric populations, we identify youth football as the sport associated with the highest risk of such injuries. Despite decreasing football participation rates over our study period, the annual incidence of football-associated acute vertebral fractures has not exhibited a proportional decline. Our findings raise concern that the relative risk of acute vertebral fracture associated with youth football has not significantly decreased over time. Elimination of dangerous tackling technique, improvement in helmet fit and technology, and availability of on-site medical care may contribute to decreased estimates in the future.

KEYWORDS:

• Sports medicine
• trauma
• youth football
• vertebral fracture
• pediatrics
• orthopedics

Acknowledgments

There are no funding sources or other acknowledgments to report for the completion of this study.

Declaration of interest

No relevant conflict of interest was reported by the authors. Author PC reports consultancy with NuVasive and author KB reports stock with Pfizer, both of which are not relevent to the current study. No other authors report any conflict of interest.

Supplementary material

Supplemental data for this article can be accessed here.