Upper extremity injuries in the National Football League: part I: hand and digital injuries

Nathan A Mall, John C Carlisle, Matthew J Matava, John W Powell, Charles A Goldfarb
American Journal of Sports Medicine 2008, 36 (10): 1938-44

BACKGROUND: Very little has been published regarding the incidence of and duration of time lost after hand injuries in professional American football players.

HYPOTHESES: (1) Hand, first ray, and finger injuries in professional American football players represent a common cause of missed time from practice and game participation. (2) The effect of upper extremity injuries differs as a function of the anatomic site involved, injury type, and athlete's position.

STUDY DESIGN: Descriptive epidemiologic study.

METHODS: A retrospective review of all documented injuries to the hand, first ray, and fingers sustained by American football players in the National Football League over a 10-year period (1996-2005) was performed using the League's injury surveillance database. The data were analyzed from multiple perspectives, with emphasis on the type of injury, athlete position, and activity at the time of injury.

RESULTS: A total of 1385 injuries occurred to the hand, first ray, and fingers over the 10 seasons studied. Of these injuries, 48% involved the fingers, 30% involved the first ray, and 22% involved the hand, with game injuries more common than practice injuries at each location. Metacarpal fractures and proximal interphalangeal joint dislocations were the 2 most common injuries. Offensive and defensive linemen were the most likely to sustain a hand injury; 80% of hand injuries were metacarpal fractures. The most common injuries to the first ray were fractures (48%) and sprains (36%), which occurred most often in athletes playing a defensive secondary position. Finger injuries were most commonly dislocations at the level of the proximal interphalangeal joint, typically involving the ulnar 2 digits. Finger injuries were most common in wide receivers and defensive secondary players. The act of tackling produced the most injuries (28%).

CONCLUSION: Upper extremity trauma, especially injury to the hand, first ray, and fingers, is a significant source of morbidity for professional football players. The results of this study may be used to implement preventive measures to help minimize these injuries.

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