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

Abstract

Softball is a popular lifetime sport due to its inclusion of both fastpitch and slowpitch varieties, although associated injuries are common. To compare softball injury rates across patient sex, age, race, injury location, mechanism, and activity. 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. 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%). 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.