Gil Joseph A, Goodman Avi D, DeFroda Steven F, Owens Brett D
Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
Orthop J Sports Med. 2018 Aug 16;6(8):2325967118790764. doi: 10.1177/2325967118790764. eCollection 2018 Aug.
Injuries to the upper extremity among collegiate athletes are reported to account for approximately 20% of all injuries; however, little is known about the proportion of these injuries that require surgery.
PURPOSE/HYPOTHESIS: The purpose of this study was to examine all shoulder injuries that required a surgical intervention and were recorded in the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP). We hypothesized that contact would be the mechanism causing injuries most at risk for needing surgery and that dislocations would be the injuries most likely to require an operative intervention.
Cross-sectional study; Level of evidence, 3.
Injury surveillance data between 2009-2010 and 2013-2014 for operative collegiate shoulder injuries and their associated sport exposures were analyzed.
A total of 185 operative shoulder injuries occurred over 3,739,004 athlete-exposures (AEs), for an overall incidence of 0.49 per 10,000 AEs. The sports with the highest incidence of operative injuries were men's football (1.31/10,000 AEs), men's wrestling (1.14/10,000 AEs), men's ice hockey (0.60/10,000 AEs), women's gymnastics (0.44/10,000 AEs), and men's swimming (0.41/10,000 AEs). Men were significantly more likely than women to sustain operative injuries for all sports combined. Of the injuries that required surgical treatment, superior labrum from anterior to posterior (SLAP) tears (46.4%), other non-SLAP glenoid labrum tears (46.2%), anterior shoulder dislocations (33.3%), and posterior shoulder dislocations (30.0%) were seen most often. There was no significant difference in injury proportion ratios (IPRs) for injuries requiring surgery when comparing contact versus noncontact mechanisms of injury (IPR, 1.0 [95% CI, 0.6-1.6]). The incidence of operative injuries sustained during competition was significantly higher compared with during practice.
The sports with the highest incidence of operative shoulder injuries were men's football, men's wrestling, men's ice hockey, and women's gymnastics. Operative shoulder injuries were more likely to occur during competition. SLAP tears, other non-SLAP glenoid labrum tears, and anterior shoulder dislocations had the highest incidence of requiring surgery. Athletes sustaining these injuries, along with their coaches and medical providers, may benefit from identifying collegiate sport participants who are at highest risk for sustaining an operative injury. This may assist in planning medical care and setting expectations, which may be critical to a young athlete's career.
据报道，大学生运动员上肢损伤约占所有损伤的20%；然而，对于这些损伤中需要手术治疗的比例知之甚少。
目的/假设：本研究的目的是调查所有需要手术干预并记录在美国国家大学生体育协会（NCAA）损伤监测计划（ISP）中的肩部损伤。我们假设接触是导致最有可能需要手术的损伤的机制，并且脱位是最有可能需要手术干预的损伤。
横断面研究；证据等级，3级。
分析了2009 - 2010年至2013 - 2014年期间大学生肩部手术损伤及其相关运动暴露的损伤监测数据。
在3739004人次运动员暴露（AE）中，共发生185例肩部手术损伤，总体发病率为每10000人次AE中有0.49例。手术损伤发生率最高的运动项目是男子足球（1.31/10000人次AE）、男子摔跤（1.14/10000人次AE）、男子冰球（0.60/10000人次AE）、女子体操（0.44/10000人次AE）和男子游泳（0.41/10000人次AE）。所有运动项目综合来看，男性比女性更易发生手术损伤。在需要手术治疗的损伤中，最常见的是从前向后的上盂唇（SLAP）撕裂（46.4%）、其他非SLAP盂唇撕裂（46.2%）、前肩关节脱位（33.3%）和后肩关节脱位（30.0%）。比较接触性与非接触性损伤机制时，需要手术的损伤的损伤比例比（IPR）无显著差异（IPR，1.0 [95% CI，0.6 - 1.6]）。比赛期间发生手术损伤的发生率显著高于训练期间。
手术肩部损伤发生率最高的运动项目是男子足球、男子摔跤、男子冰球和女子体操。手术肩部损伤更可能发生在比赛期间。SLAP撕裂、其他非SLAP盂唇撕裂和前肩关节脱位需要手术的发生率最高。遭受这些损伤的运动员及其教练和医疗人员，可能会从识别出最易发生手术损伤的大学生运动员中受益。这可能有助于规划医疗护理并设定预期，这对年轻运动员的职业生涯可能至关重要。
