Geßlein Markus, Rüther Johannes, Millrose Michael, Bail Hermann Josef, Martin Robin, Schuster Philipp
Department of Orthopaedics and Traumatology, Paracelsus Medical University, Nuremberg, Germany.
Department of Hand Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau am Staffelsee, Germany.
Orthop J Sports Med. 2021 Jan 25;9(1):2325967120973996. doi: 10.1177/2325967120973996. eCollection 2021 Jan.
Hand and wrist injuries are a common but underestimated issue in taekwondo. Detailed data on injury risk, patterns, and mechanism are missing.
To evaluate (1) the fight time exposure-adjusted injury incidence rate (IIR) and clinical incidence and (2) injury site, type, sport-specific mechanism, and time loss in taekwondo.
Descriptive epidemiology study.
Athletes from a single national Olympic taekwondo training center were investigated prospectively for hand and wrist injuries during training and competition over 5 years. The Orchard Sports Injury Classification System Version 10 was used to classify injury type, and analysis of the anatomic injury site was performed. The mechanism of injury was classified as due to either striking or blocking techniques.
From a total of 107 athletes, 79 athletes (73.8%) with a total exposure time of 8495 hours were included in the final data set. During the study period, 75 injuries of the hand and wrist region were recorded despite the athletes using protective hand gear. The IIR was 13.9 (95% CI, 10.5-17.5) and was significantly higher during competition. The clinical incidence as an indicator for risk of injury was 60.7% (95% CI, 50.9-70.5). Finger rays were the most affected location (68%), and fractures (43%) and joint ligament injuries (35%) were the most common type of injury. Significantly more injuries were found on the dominant hand side ( < .001). Comparison of injury mechanisms demonstrated significantly more injuries at the finger rays deriving from blocking techniques ( = .0104). The mean time loss for all hand and wrist injuries was 15.7 ± 13.5 days (range, 3-45 days) and was highest for distal radial fractures, with a mean of 39.7 ± 4.8 days (range, 32-45 days).
There was a significantly higher IIR for acute hand and wrist injuries in elite taekwondo athletes during competition, which resulted in considerable time loss, especially when fractures or dislocations occurred. Significantly more injuries to the finger rays were found during blocking despite the use of protective hand gear. Improvement of tactical skills and blocking techniques during training and improved protective gear appear to be essential for injury prevention.
手和腕部损伤在跆拳道运动中很常见，但却未得到充分重视。目前尚缺乏关于损伤风险、模式及机制的详细数据。
评估（1）经过比赛时间暴露调整后的损伤发生率（IIR）及临床发生率，以及（2）跆拳道运动中手和腕部的损伤部位、类型、特定运动机制及失能时间。
描述性流行病学研究。
对来自一个国家奥林匹克跆拳道训练中心的运动员进行了为期5年的前瞻性调查，记录他们在训练和比赛期间手和腕部的损伤情况。采用果园运动损伤分类系统第10版对损伤类型进行分类，并对解剖学损伤部位进行分析。损伤机制分为击打技术或格挡技术所致。
在总共107名运动员中，79名运动员（73.8%）被纳入最终数据集，总暴露时间为8495小时。在研究期间，尽管运动员使用了手部防护装备，但仍记录到75例手和腕部损伤。IIR为13.9（95%CI，10.5 - 17.5），在比赛期间显著更高。作为损伤风险指标的临床发生率为60.7%（95%CI，50.9 - 70.5）。指骨是受影响最严重的部位（68%），骨折（43%）和关节韧带损伤（35%）是最常见的损伤类型。优势手侧的损伤明显更多（P <.001）。损伤机制比较显示，因格挡技术导致的指骨损伤明显更多（P = 0.0104）。所有手和腕部损伤的平均失能时间为15.7 ± 13.5天（范围3 - 45天），桡骨远端骨折的失能时间最长，平均为39.7 ± 4.8天（范围32 - 45天）。
精英跆拳道运动员在比赛期间急性手和腕部损伤的IIR显著更高，这导致了相当长的失能时间，尤其是发生骨折或脱位时。尽管使用了手部防护装备，但在格挡过程中发现指骨损伤明显更多。在训练中提高战术技能和格挡技术以及改进防护装备对于预防损伤似乎至关重要。
