Norceide Dogerno, Onor Gabriel I, Akingbola Oluwatomi, Justice William, Amponsah Nana F, Okulaja Abimbola, Onor Ifeanyichukwu, Okoronkwo Michael, Nwizu Chibuikem, Pedowitz David
Drexel University College of Medicine, Philadelphia, PA, USA.
Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Foot Ankle Orthop. 2025 Jun 26;10(2):24730114251342797. doi: 10.1177/24730114251342797. eCollection 2025 Apr.
Fractures of the toes are among the most frequently diagnosed lower extremity fractures. In sports, toe fractures may present after diverse mechanisms of injury, varying severity, and varying implications for management. This study aimed to discern trends in toe fractures presenting to US emergency departments (EDs) particularly in association with sports and recreational activities. An additional aim of the study was to identify if rates of toe fracture presentation significantly decreased during the year 2020 at the height of the COVID-19 pandemic.
We queried the National Electronic Injury Surveillance System (NEISS) database to identify toe fractures presented to US EDs from 2013 to 2022. The data outputs were analyzed by age group, sex, sport/recreational activity, and year. US Census data were used for calculation of incidence rates (IR) in 100,000 person-years. χ tests and regression analyses were performed to determine significance. Grubbs's test was performed to determine significant yearly outliers with particular attention to the year 2020.
A total of 921,033 toe fractures were identified across US EDs, with 175,864 cases associated with sports and recreation. Exercise (IR = 140.3) had the leading IR among sports/recreation followed by cycling (IR = 136.8), basketball (IR = 136.8), and football (IR = 94.9). Males accounted for 40.8% of fractures (IR = 23.0), whereas females contributed 59.2% (IR = 32.8). Toe fractures peaked in the 10- to 14-year-old age group in both males and females. Sports- and recreation-related toe fractures did not significantly decrease from 2013 to 2022, although all-cause toe fractures did significantly decrease as shown by a value of .0037 from linear regression analysis of yearly trend in all toe fractures. The year 2020 was a significant outlier with a decrease in sports-related toe fractures though there was no significant decrease in all-cause toe fractures in 2020.
Sports- and recreation-related toe fractures did not significantly decrease from 2013 to 2022, although a significant decrease in all-cause toe fractures was observed. Toe fractures continue to peak in the pediatric age groups, particularly 10-14 year-olds. Youth sports and recreation officials should be aware of the risks of toe fractures to aid in prevention. Level III, epidemiologic database, retrospective cohort studies.
脚趾骨折是最常被诊断出的下肢骨折之一。在体育运动中，脚趾骨折可能由多种损伤机制导致，严重程度各异，对治疗的影响也不同。本研究旨在探究美国急诊科收治的脚趾骨折的趋势，特别是与体育和娱乐活动相关的情况。该研究的另一个目的是确定在2020年新冠疫情高峰期，脚趾骨折就诊率是否显著下降。
我们查询了国家电子伤害监测系统（NEISS）数据库，以确定2013年至2022年期间美国急诊科收治的脚趾骨折情况。数据输出按年龄组、性别、体育/娱乐活动和年份进行分析。美国人口普查数据用于计算每10万人年的发病率（IR）。进行χ检验和回归分析以确定显著性。进行格拉布斯检验以确定年度显著异常值，尤其关注2020年。
美国急诊科共确诊921,033例脚趾骨折，其中175,864例与体育和娱乐活动有关。在体育/娱乐活动中，锻炼的发病率最高（IR = 140.3），其次是骑自行车（IR = 136.8）、篮球（IR = 136.8）和足球（IR = 94.9）。男性占骨折病例的40.8%（IR = 23.0），而女性占59.2%（IR = 32.8）。男性和女性的脚趾骨折在10至14岁年龄组达到峰值。尽管对所有脚趾骨折的年度趋势进行线性回归分析显示，所有原因导致的脚趾骨折显著下降（P值为0.0037），但2013年至2022年期间，与体育和娱乐相关的脚趾骨折并未显著下降。2020年是一个显著的异常值，与体育相关的脚趾骨折有所下降，不过2020年所有原因导致的脚趾骨折没有显著下降。
尽管观察到所有原因导致的脚趾骨折显著下降，但2013年至2022年期间，与体育和娱乐相关的脚趾骨折并未显著下降。脚趾骨折在儿童年龄组中继续达到峰值，尤其是10至14岁的儿童。青少年体育和娱乐活动官员应意识到脚趾骨折的风险，以协助预防。三级，流行病学数据库，回顾性队列研究。
