Upper extremity orthopedic softball injuries presenting to the emergency department: epidemiology across the lifespan.

ABSTRACT

BACKGROUND: Softball is a popular lifetime sport due to its inclusion of both fastpitch and slowpitch varieties, although associated injuries are common. OBJECTIVE: To compare softball injury rates across patient sex, age, race, injury location, mechanism, and activity. METHODS: The National Electronic Injury Surveillance System (NEISS) was queried for all upper extremity softball injuries in patients 10-85+ years old presenting to United States emergency departments between 2012 and 2021. RESULTS: Significantly more of the 178,303 total weighted upper extremity injuries occurred in female (68.1%) than male (31.9%) athletes (p < .001). Male patients (mean 34.9 ± 13.6 years) were older than female patients (17.4 ± 8.4; p = .019). The average incidence rate of UE injuries from 2012-2021 was 187.9 per 100,000 persons, with a significant decrease in injury incidence across the timespan (p < .001). The lowest annual injury incidence (74.7 per 100,000 persons) occurred in 2020. In patients 10-18 years old, female patients accounted for 95.1% of all injuries, whereas male patients accounted for 72.1% of all injuries in patients aged ≥23. Compared to male patients, females more frequently experienced hand (p < .001), lower arm (p = .007), shoulder (p < .001), and wrist (p < .001) injuries in patients 10-18 years old, finger (p < .001), upper arm (p = .016), and wrist (p < .001) injuries in patients 19-22, and finger injuries (p < .001) in patients aged 23 +. Across all ages, the greatest proportion of injuries were treated and released (p < .001). Most injuries occurred while fielding (41.8%) and due to player-ball contact (36.8%). CONCLUSION: Softball injury ED presentations declined across a decade, including a precipitous drop and rebound effect due to the COVID-19 pandemic. Across the lifespan, upper extremity injuries progressively shifted from female-predominant in younger athletes to male-predominant in adults.