A few cases series studies have reported the epidemiology of wrist and hand injuries in high-level football players, but the rate and type of surgical procedures performed in these athletes remains unknown.
This was a retrospective review and epidemiologic analysis of all wrist and hand injuries documented and the procedures performed in a single National Collegiate Athletic Association (NCAA) Division I football team, between 2003 and 2020. Data collected were number of hand and wrist injuries, injury laterality, diagnosis, number of surgical procedures performed, and indication for surgery. Epidemiologic analysis was performed by reporting the number and rate of different injuries and recorded diagnoses. The proportion of athletes who required surgical treatment was reported as a rate along with the different indications for surgical intervention.
A total of 145 hand and wrist injuries were recorded in 122 NCAA Division I athletes, over a period of 17 years. Of those injuries, 79 (79/145, 54%) were left-sided and 70 (70/149, 66%) were right-sided. The annual rate of injury was 8.7 hand and wrist injuries per year. Recorded diagnoses were thumb sprain (37/145, 26%), wrist sprain (23/145, 16%), metacarpal fracture (19/145, 13%), proximal interphalangeal (PIP) joint dislocation (15/145, 10%), hand laceration or contusion (14/145, 10%), wrist fracture (12/145, 8%), 2-4 finger sprain (7/145, 5%), 2-4 finger fracture (6/145, 4%), thumb fracture (5/145, 3%), distal interphalangeal (DIP) joint dislocation (3/145, 2%), thumb subluxation (2/145, 1%), and mallet finger (2/145, 1%). Thirty-two out of these 145 injuries (23%) required surgical treatment, resulting in a hand and wrist procedure rate of 2% in this group of elite football players. The most common indication for surgery was 3rd degree sprain to the ulnar collateral ligament of the thumb (11/32, 34%). Additional injuries that required operative intervention included: scaphoid fracture (7/32, 21%), wrist carpal joint sprain (5/32, 16%), finger or thumb fracture (3/32, 9%), metacarpal fracture (3/32, 9%), injury to the triangular fibrocartilage complex (2/33, 6%), and scapholunate dislocation (1/32, 3%).
The rate of hand and wrist injuries in NCAA Division I football players was 8.7 injuries per year, while the annual procedure rate was about 2 hand and wrist surgeries per year. Sprains of the ulnar collateral ligament of the thumb were the most common reason for surgery in these athletes. Wrist fractures and ligament injuries also were a common indication for surgery. These results suggest an opportunity for protective equipment that could decrease the incidence of thumb and wrist injuries in American football.