Objectives: Snowboarding is a high energy sport associated with traumatic musculoskeletal injury. Although the pediatric population constitutes most snowboarding injuries, no study has investigated this cohort in further detail. The purpose of this study is to analyze underlying etiologies, diagnoses, and injury trends of pediatric snowboarding injuries presenting to United States emergency departments. Methods: Data from the National Electronic Injury Surveillance System (NEISS) were analyzed for pediatric snowboarding injuries (≤18 years old) from January 1, 2012 to December 31, 2022. Data were collected for mechanism of injury, diagnosis, location of injury, and disposition. National estimates (NE) were calculated using the statistical sample weight of the corresponding hospital assigned by the NEISS. Linear regressions were used to analyze injury trends over time. Results: In total, 3,036 (NE=120,140) pediatric snowboarding injuries were included in this study. Average age was 14.0 ± 2.7 years. The most common mechanism of injury was impact with the ground (NE=97,120, 80.8%). The most common diagnoses were fractures (NE=48,886, 40.7%), strains/sprains (NE=22,948, 19.1%), and concussions (NE=12,553, 10.4%). Most common fractures occurred at the wrist (NE=18,122, 37.1%), lower arm (NE=12,348, 25.3%), and shoulder (NE=9,073, 18.6%). Overall, 96.1% injuries were treated without admission. There were decreases of 1,051 injuries (p<0.01), 299 fractures (p=0.04), 298 strains/sprains (p<0.001), and 143 concussions (p<0.01) per year during the study period. Mechanisms of injury demonstrated decreasing annual trends of 784 impact with ground injuries per year (p<0.01), 161 not specified injuries per year (p<0.01), and 42 impact with inanimate object injuries per year (p=0.03). Conclusions: There was a large decline in pediatric snowboarding injuries over the last decade. Given the small proportion requiring hospital admission, the decline may reflect increasing on-site management of less-severe snowboarding injuries. These findings also highlight the importance of protective equipment considering the large proportion of injuries secondary to impact with the ground.
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