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Orthopedic Sports Injuries: Off The Sidelines And Into The Emergency Department

April 2003


Sports injuries present unique challenges to the emergency physician. From the little-leaguer to the cardiac rehabilitation patient, millions of Americans participate in sports or fitness activities. While an athletic injury rarely requires a life- or limb-saving intervention in the ED, the personal impact on the player can be monumental. Emergency physicians must be expert in the diagnosis and initial treatment of sports-related injuries.

Each year in the United States, an estimated 150 million adults participate in some type of non-work-related physical activity, and approximately 30 million children and adolescents participate in organized sports.1 From July 2000 through June 2001, an estimated 4.3 million sports- and recreation-related injuries were treated in U.S. EDs, comprising 16% of all unintentional injury-related ED visits.1 The percentage was highest for those 10-14 years old and lowest for those over 45. Among all ages, rates were higher for males than for females.1 Males are most often injured during playground activities, cycling,football, and basketball. In girls, most injuries are caused by playground activities, basketball, cycling, and general exercise.1

The most frequent diagnoses include strains/sprains (29.1%), fractures (20.5%), contusions /abrasions (20.1%), and lacerations (13.8%). The body parts most frequently involved are the ankles (12.1%), fingers (9.5%), face (9.2%), head (8.2%), and knees (8.1%). Overall, 2.3% of people with sports- and recreation-related injuries were hospitalized.1 (See Table 1.)

This issue of Emergency Medicine Practice describes management strategies for common orthopedic sports injuries. Prior issues of Emergency Medicine Practice, such as the January 2000 issue on mild head trauma, the February 2000 issue on back pain, the October 2001 issue on cervical spine injuries (updated April 2009), the November 2001 issue on wrist injuries, and the May 2002 issue on ankle injuries, also provide pertinent information.

“When I played pro football, I never set out to hurt anybody
deliberately, unless it was, you know, important, like a league
game or something.”—Dick Butkus
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