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Upper extremity injuries in the National Football League: part II: elbow, forearm, and wrist injuries

John C Carlisle, Charles A Goldfarb, Nathan Mall, John W Powell, Matthew J Matava
American Journal of Sports Medicine 2008, 36 (10): 1945-52

BACKGROUND: Very little information is available regarding the incidence, causative mechanisms, and expected duration of time lost following upper extremity injuries in professional American football players.

HYPOTHESES: (1) Upper extremity injuries in professional American football players are a common cause of missed time from practice and game participation. (2) The effect of upper extremity injuries differs as a function of the site involved and the athlete's position.

STUDY DESIGN: Descriptive epidemiologic study.

METHODS: A retrospective review of all documented injuries to the elbow, forearm, and wrist sustained by all players in the National Football League over a 10-year period (1996-2005) was performed using the League's injury surveillance database. An injury was considered significant if it resulted in premature cessation of (or absence from) at least 1 practice, game, or training event. The data were analyzed from multiple perspectives, with emphasis on the type of injury, athlete position, and activity at the time of injury.

RESULTS: There were 859 total injuries over the 10-year period: 58% involved the elbow, 30% involved the wrist, and 12% involved the forearm. Ligamentous injuries were the most common diagnosis in the elbow and wrist, with wrist sprains the most common of all diagnoses. Fractures were the most common injury occurring in the forearm. For all 3 anatomic locations, game injuries were much more common than practice injuries by a factor of 2.8 to 1. Forearm injuries led to a mean of 42 days lost, wrist injuries led to a mean of 27 days lost, and elbow injuries led to an average of 22 days lost. Fractures and dislocations led to the greatest amount of time lost (47 days and 53 days, respectively). Tackling was the activity most often (24%) implicated as causing injuries to the elbow, forearm, and wrist. Offensive and defensive linemen were most commonly injured. Elbow injuries were the most common at these positions, constituting approximately 75% of all injuries. Defensive backs sustained the greatest number of forearm injuries, approximately double the total number at any other position.

CONCLUSION: Upper extremity trauma is a significant issue for professional football players. In particular, the high incidence rates of elbow injuries in linemen and forearm injuries in defensive backs warrant further scrutiny.

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