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Open access Review

Epidemiology of sports injuries in

basketball: integrative
systematic review
Carlos Vicente Andreoli,1 Bárbara Camargo Chiaramonti,1 Elisabeth Biruel,1
Alberto de Castro Pochini,1 Benno Ejnisman,1 Moises Cohen2

To cite: Andreoli CV, Abstract psychosocial well-being, weight control,

Chiaramonti BC, Biruel E, et al. Introduction  Basketball is a contact sport with complex and less abuse of alcohol and drugs, among
Epidemiology of sports injuries
in basketball: integrative
movements that include jumps, turns and changes in others5–7—participating in a sport with so
systematic review. BMJ Open direction, which cause frequent musculoskeletal injuries in much physical demand, such as basketball,
Sport & Exercise Medicine all regions of the body. where the athlete performs repetitive jumps
2018;4:e000468. doi:10.1136/ Objective  This is an integrative systematic review of the during games and training, abrupt changes
bmjsem-2018-000468 epidemiology of musculoskeletal injuries in basketball.
in direction, running and deceleration,8 may
Methods  This is an integrative review based on the
following sources of information: PubMed/MEDLINE, result in a greater risk of injury. This leads
Accepted 20 November 2018
Embase, LILACS, BBO-Biblioteca Brasileira de Odontologia, to an increase in health expenses and visits
IBECS-Índice Bibliográfico Espanhol em Ciências da Saúde, to doctors and hospitals, reduction in court
nursing journals, dental journals and core clinical journals time, and increased risk of new injuries.9 10
in the last 10 years with studies addressing the general Several studies have already been published
epidemiology of sports injuries in basketball. describing injuries in basketball. Some focus
Results  In total, 268 articles were selected, of which 11 on professional athletes,11 others focus on
were eligible for the integrative review. A total of 12 960 college students12 or high school students,13 14

by copyright.
injuries were observed, most of which occurred in the and others on adult athletes.15 Some studies
lower limbs (63.7%), with 2832 (21.9%) ankle injuries and
focus only on a specific region of the body
2305 (17.8%) knee injuries. Injuries in the upper limbs
or a specific diagnosis, such as concussion,16
represented 12%–14% of the total injuries. Children and
adolescents received head injuries more often compared shoulder17 or ankle injury,18 and many
with the other age and skill categories. In the adult compare injury rates between sexes.19
category, there was an increased prevalence of injuries in The understanding of basketball injury
the trunk and spine. In the upper limbs, hands, fingers and epidemiology is an important first step in
wrists were affected more frequently than the shoulders, the development of targeted, evidence-based
arms and forearms. In the masters’ category, there was an interventions to provide recommendations
increase in the incidence of thigh injuries. for injury prevention. The objective of this
Conclusion  The lower limbs were the most affected, study was to perform an integrative review of
with the ankle and knee joints having the highest the epidemiology of musculoskeletal injuries
prevalence of injuries regardless of gender and category.
in basketball.
Further randomised studies, increased surveillance and
epidemiological data collection are necessary to improve
knowledge on sports injuries in basketball and to validate Methodology
© Author(s) (or their
employer(s)) 2018. Re-use
the effectiveness of preventive interventions. Literature search
permitted under CC BY-NC. No An electronic search was performed in the
commercial re-use. See rights
and permissions. Published by
following databases: PubMed/MEDLINE,
BMJ. Embase, LILACS, and thematic databases
1
Department of Orthopedics Introduction included in the Portal de Pesquisa da Biblio-
and Traumatology, Universidade Created in the USA more than a century ago teca Virtual em Saúde (Virtual Health
Federal de São Paulo (UNIFESP), by James Naismith,1 basketball has become Library Research Portal): BBO-Biblioteca
Escola Paulista de Medicina, São one of the most popular sports in the world, Brasileira de Odontologia (Brazilian Library
Paulo, Brazil
2 particularly in the USA.2 3 In Brazil, basket- of Dentistry) and IBECS-Índice Bibliográfico
Universidade Federal de São
Paulo (UNIFESP), Escola Paulista ball is one of the four most popular sports Espanhol em Ciências da Saúde (Spanish
de Medicina, São Paulo, Brazil according to the Ministry of Sports.4 Bibliographic Index in Health Sciences).
Despite all the benefits resulting from Other sources of information were also
Correspondence to
participation in sports—such as improved included, such as nursing journals, dental
Dr Carlos Vicente Andreoli; ​ body composition, cardiorespiratory function, journals, core clinical journals, and the Coor-
andreolicruz@​uol.​com.​br increased strength, improved self-esteem/ denação de Aperfeiçoamento de Pessoal de

Andreoli CV, et al. BMJ Open Sport Exerc Med 2018;4:e000468. doi:10.1136/bmjsem-2018-000468   1

 BMJ Open Sport Exerc Med: first published as 10.1136/bmjsem-2018-000468 on 27 December 2018. Downloaded from http://bmjopensem.bmj.com/ on January 11, 2023 by guest. Protected
Open access

Nível Superior (CAPES; Brazilian Federal Agency for the basketball dental injuries and basketball concussions; (6)
Support and Evaluation of Graduate Education) Thesis articles that presented in the results section the percent-
Bank, which is a representative of the so-called grey litera- ages of the injuries without specifying the region of the
ture and internet sites. Language or region filters were not body (eg, foot, ankle, knee and so on), referring to only
included. The elaboration of the search strategies gave general terms as upper limbs, lower limbs and trunk; and
the research greater sensitivity by combining the terms (7) articles that only addressed more prevalent injuries
extracted from the DeCS/MesH and synonyms: basket- in emergency departments or surgical basketball injuries
ball, epidemiology, athletic injuries, sprains and strains. because these data reveal a portion of possible basketball
Thus, the eligibility criterion was to identify articles that injuries rather than overall totality/epidemiology. The
discussed the general epidemiology of sports injuries in possible inconsistencies were identified, discussed and
basketball. resolved by consensus.
To determine whether a study should be included, the
titles and abstracts of all references obtained were eval- Procedures for creating the database
uated by two medical reviewers. The extracted studies To create this database, the following steps were taken: (1)
were assessed based on the inclusion and exclusion extraction of the number of injuries detailed by the site
criteria. The inclusion criteria were as follows: (1) articles of each study—when the study did not present the total
published in the last 10 years; (2) studies addressing the number of injuries but did report the relative frequency,
general epidemiology of sports injuries in basketball; and the absolute frequencies were computed by multiplying
(3) athletes of any age, of both sexes, and professional, the total number of injuries by the relative frequencies;
amateur and recreational basketball practitioners. The (2) checking and rechecking of total injuries in each
exclusion criteria were as follows: (1) review articles; (2) study; and (3) organisation of the total absolute frequen-
case reports; (3) articles dealing with Paralympic sports; cies, by sex and by category of the participant.
(4) studies on the general epidemiology of sports inju- Eleven studies were included in this review, as shown in
ries, including basketball, that did not present specific figure 1. The main characteristics of the studies included
injury percentages for each sport; (5) items that solely in the integrative review are described in table 1.
addressed some type of specific basketball injury, for The objectives of the 11 studies included in the anal-
example, articles reporting knee injuries in basketball, or ysis (table 1) were as follows: to verify the association

by copyright.

Figure 1  Selection of the studies surveyed in the electronic databases and grey literature. Preferred Reporting Items for
Systematic Reviews and Meta-Analyses algorithm. BBO, Biblioteca Brasileira de Odontologia (Brazilian Library of Dentistry);
IBECS, Índice Bibliográfico Espanhol em Ciências da Saúde (Spanish Bibliographic Index in Health Sciences).

2 Andreoli CV, et al. BMJ Open Sport Exerc Med 2018;4:e000468. doi:10.1136/bmjsem-2018-000468

 Table 1  Main characteristics of the studies included in the integrative review on basketball epidemiology
Sample
Journal Year Title Authors Method Objective Local Category Period size

The American 2008 The epidemiology of US high Laurel A Borowski, Ellen E Retrospective. Adolescents by gender (check EUA Adolescents 2005–2007 1.94*
Journal of Sports school basketball injuries, 2005– Yard, Sarah H Fields, R Dawn Descriptive epidemiology rates and patterns of basketball
Medicine 2007 Comstock study. injuries between genders and by
type of exposure).
Journal of Athletic 2014 Epidemiologic comparison of Erica N Fletcher, Lara B Retrospective. Incidence in adolescents EUA Adolescents 2005–2011 1.68*
Training injured high school basketball McKenzie, Descriptive epidemiology (comparison of injury patterns in
athletes reporting to emergency R Dawn Comstock study. emergency departments and in the
departments and the athletic athletic training setting).
training setting
Journal of Athletic 2007 Subsequent injury patterns in Mitchell J Rauh, Caroline Prospective. Comparison of subsequent injuries EUA Adolescents 1995–1997 6083
Training girls’ high school sports A Macer, Ming Ji, Denise L Observational cohort. between sports with girls.
Wiksten
Acta Ortopédica 2007 Incidência de lesões Alexandre S da Silva, Rene J Prospective. Incidence in women. Brazil Professional 1999–2000 66
Brasileira musculoesqueléticas em atletas Abdalla, Mauro Fisberg Prospective analysis.
de elite do basquetebol feminino
The Physician and 2014 Epidemiology of basketball, Kim D Barber Foss, Greg D Prospective. Injury in children (incidence of EUA Children 2009–2010 162
Sportsmedicine soccer, and volleyball injuries in Myer, Timothy E Hewett Observational studies— injury in female athletes). United
middle-school female athletes transversal or cross- States
section.
Journal of Sports 2016 Quality of life perception of NB Moreira, O Mazzardo, GC Prospective. Masters injuries, (association Brazil Masters 2012 410
Sciences basketball master athletes: Vagetti, V De Oliveira, W De Non-probabilistic cross- between SI, PA) and injuries with
association with physical activity Campos sectional character with related dimensions perception
level and sports injuries correlational descriptive of HRQoL in basketball master
design. athletes.
Journal of Science 2017 Game injuries in relation to Masaru Teramoto, Chad L Prospective. Check association between game EUA Professional 2012–2015 1443

Andreoli CV, et al. BMJ Open Sport Exerc Med 2018;4:e000468. doi:10.1136/bmjsem-2018-000468

and Medicine in game schedules in the National Cross, Daniel M, Cushman, Prospective cohort study. schedule and injuries. -United
Sport Basketball Association Travis G Maak, David J States
Petron, Stuart E Willick
Science & Sports 2015 Injuries of high-level female M Buffet, N Morel, M Prospective. Incidence in women (professionals France Professional 2012–2013 11
basketball players during one Navacchia, J Voyezd, J Vella- Study prospective cohort. in the France, to define prevention
competitive season Boucaude, P Edouard strategies).
Sports Medicine, 2012 Incidence and pattern of injuries Oluwatoyosi Babatunde Alex Prospective. Incidence in adolescents (in Nigeria Adolescents 2010 141
Arthroscopy, among adolescent basketball Owoeye, Ashiyat Kehinde Prospective cohort study. Nigeria).
Rehabilitation, players in Nigeria Akodu, Bayonle Matt
Therapy and Oladokun, Sunday Rufus
Technology Akinwumi Akinbo
Science & 2011 Injury reporting rates and injury Ashley S Long, Jatin P Prospective. Compare with other sport/activity. EUA - Adolescents 2010–2011 20
Medicine concealment patterns differ Ambegaonkar, Patty M Observational cohort. United
between high-school cirque Fahringer States
performers and basketball players
The American 2006 Injury risk in professional John R Deitch, Retrospective. Compare sex. EUA - Professional 1996–2002 1145
Journal of Sports basketball players: a comparison Chad Starkey, Sheri L Observational cohort. United
Medicine of Women’s National Basketball Walters, J Bruce Moseley States
Association and National
Basketball Association athletes

*The study did not present the total number, but rather the relative frequency; the absolute frequencies were computed by multiplying the total number of injuries by the relative frequencies.
Open access

3
HRQoL, health-related quality of life; PA, physical activity; SI, sports injuries.

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between game schedule and injuries; to compare basket- hip and leg, which accounted for 17.5% of injuries. In
ball with other sports/physical activities or sports; to males, 28.4% of injuries occurred in the ankle and foot,
compare subsequent injuries among sports; to verify followed by the thigh, hip and leg (19.3%) and the knee
differences in injuries between sexes; to compare injury (17.5%). When the injuries were analysed according to
patterns in emergency departments and in the athletic the age/level of skill category, the site with the most inju-
training setting; to assess the incidence of injuries; and ries in children and adolescents was the ankle and the
to assess the association between physical activity level, foot (37.7%, 2807 injuries), followed by the knee (16.3%,
physical activity dependence and injuries with the dimen- 1214 injuries), head and neck (13.7%, 1024 injuries),
sions related to the perception of health-related quality and the hands, fingers and wrists (8.9%, 662 injuries).
of life and health. Despite the different objectives of the For professional athletes, the injury frequencies were as
included studies, in all studies it was possible to verify the follows: 24.8% (1310 injuries) of injuries occurred in the
number of basketball injuries in each part of the body, foot and the ankle, followed by the thigh, hip and leg with
either through the absolute number that was indicated in 1074 injuries (20.4%), the knee with 19.5% (1027 inju-
the study or through the absolute frequencies multiplied ries), and the trunk and spine with 586 injuries (11.1%).
by the total number of injuries. In this way, the following Only one study referred to the masters’ category, and in
results were obtained. this study 31.4% of the injuries (75 injuries) occurred in
the thigh, hip and leg, followed by the knees with 64 inju-
Inferential procedures ries (26.8%) and the ankle and the foot with 39 injuries
In the inferential analysis, the following software were (16.3%) (table 2).
used: R (V.3.3.2) and RStudio (V.1.0.136). The ‘meta’
library was adopted for the estimation of meta-analysis
Inferential analysis
models. The overall proportions of knee and ankle and
The proportions of injuries were estimated by meta-anal-
foot injuries were estimated, along with the respective CIs
ysis models, which weighted injury frequencies by study
and weights for each study. Tests were also performed to
sizes. Figure 2 presents the proportions of knee and
verify whether the OR between injuries at different sites
ankle and foot injuries estimated by fixed-effects and
was the same (OR=1). For this analysis, the knee was
random-effects models and the CIs and weight of each
adopted as a reference site.
study in this estimation. Notably, there is significant

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heterogeneity in the studies, measured by the I2 statistic
Results (95% and 97%, respectively). The estimated proportion
Characteristics of the identified studies of knee injuries was 0.18 (95% CI 0.17 to 0.19) for the
Descriptive statistics of the studies fixed-effects model and 0.22 (95% CI 0.18 to 0.27) for
A total of 268 articles were selected, of which 11 articles the random-effects model. The estimated proportion of
were eligible for the integrative review. Of the studies ankle and foot injuries was 0.33 (95% CI 0.32 to 0.33) for
included in the study, it was possible to extract the number the fixed-effects model and 0.29 (95% CI 0.24 to 0.34)
of absolute injuries in females in seven studies.20–26 For for the random-effects model.
males, five studies were used to extract the number of
injuries.20 24 26–28 Two other studies did not specify the
gender, and the data were only used for the total sum of ORs between injury sites
the injuries.29 30 The ORs between injuries were also estimated using a
With regard to the region of the participants, seven meta-analysis model, using knee injuries as the reference,
(63.6%) studies were from the USA, two (18.2%) were which was the most frequent site of injury. With ankle and
from Brazil, one (9.1%) was from France and one (9.1%) foot combined, this category of injuries proportionally
was from Nigeria. With regard to the age and level of exceeded that of knee injuries. However, this category is
skill category, most of the studies addressed injuries in less specific.
adolescents (45.5%, 5 studies), followed by injuries in The results of the OR comparison tests in the fixed-ef-
professionals (36.4%, 4 studies, table 1). Children and fect models are presented in table 3. The test evaluates
masters were cited in only one study each, which repre- whether the OR is equal to 1 and rejects the hypothesis in
sented 9.1% and 9.1% of the studies, respectively. cases of low p values (p<0.05). All OR values were greater
than 1, except for the ankle and foot, which had a value
Descriptive statistics of injuries less than 1. The p value for all comparisons was statis-
In total, 12 960 injuries were computed and extracted tically significant (p<0.0001). Thus, the probability of
from the studies (table 2). The knee and the ankle were knee injury was greater than the probability of injury to
the most affected sites, with 2832 (21.9%) and 2305 the thigh, hip and leg, head and neck, trunk and spine,
(17.8%) injuries, respectively. When analysed separately, shoulder arm and forearm, and hands, fingers and wrists.
this trend was repeated for injuries in both females and The probability of knee injury was only lower than the
males. With regard to injuries in females, 19.5% of injuries probability of ankle or foot injury. It was not possible to
occurred in the ankle and 20.6% occurred in the knee. calculate the comparisons of knee with ankle only and
The third most affected region in females was the thigh, knee with foot only using the set of studies.

4 Andreoli CV, et al. BMJ Open Sport Exerc Med 2018;4:e000468. doi:10.1136/bmjsem-2018-000468

 Table 2  Injury percentages by anatomical segments in relation to total number, female sex, male sex, children and adolescents, professionals, and masters
Children and
Total*† Female*‡ Male*† adolescents§ Professionals¶ Masters†**
Injuries (n) % Injuries (n) % Injuries (n) % Injuries (n) % Injuries (n) % Injuries (n) %

Total 12 960 100.0 4291 100.0 4602 100.0 7449 100.0 5272 100.0 239 100.0
Ankle and foot 4156 32.1 1302 30.3 1308 28.4 2807 37.7 1310 24.8 39 16.3
Ankle 2832 21.9 837 19.5 670 14.6 1910 25.6 922 17.5 – –
Foot 683 5.3 197 4.6 265 5.8 295 4.0 388 7.4 – –
Not determined 641 4.9 268 6.2 373 8.1 602 8.1 – – 39 16.3
Knee 2305 17.8 882 20.6 807 17.5 1214 16.3 1027 19.5 64 26.8
Thigh, hip and leg 1784 13.8 752 17.5 886 19.3 635 8.5 1074 20.4 75 31.4
Head and neck 1468 11.3 417 9.7 384 8.3 1024 13.7 437 8.3 7 2.9
Hands, fingers and fist 1133 8.7 369 8.6 386 8.4 662 8.9 454 8.6 17 7.1

Andreoli CV, et al. BMJ Open Sport Exerc Med 2018;4:e000468. doi:10.1136/bmjsem-2018-000468

Trunk and spine 975 7.5 325 7.6 508 11.0 371 5.0 586 11.1 18 7.5
Shoulder, arm and forearm 585 4.5 182 4.2 267 5.8 238 3.2 328 6.2 19 7.9
Others 554 4.3 62 1.4 56 1.2 498 6.7 56 1.1 – –
*Includes all studies, whether for females, males or both.
†For comparison and simplification purposes, seven lesions classified as head and chest in the original study were included in the head and neck category.
‡Includes all studies presenting discrimination of lesions for females.
§Includes all studies, whether for females, males or both for children and adolescents.
¶Includes all studies, whether for females, males or both for professional athletes.
**Only one study addresses a masters’ category.
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Figure 2  Proportions of knee and ankle and foot injuries estimated by fixed-effects and random-effects models and the CIs
and weight of each study in this estimation knee.

Discussion these values were 14.6% and 17.5% in males, respec-

In this study, more than 12 000 basketball injuries were tively. In the children and adolescent category, ankle
analysed from the 11 included studies, and the results injuries accounted for 25.6% and knee injuries
showed that there were more injuries in the lower limbs accounted for 16.3%. In professionals, ankle and knee
(63.7% of the injuries), regardless of gender (male, injuries accounted for 17.5% and 19.5% of all injuries,

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65.2%; female, 68.4%) or level (professionals 64.7%, respectively. Finally, in master athletes, knee inju-
master 74.5%, and children and adolescents 62.5%). ries accounted for 26.8%, and foot and ankle injuries
These data are in accordance with the literature.31–33 accounted for 16.3%. It was not possible to differen-
In a Women’s National Basketball Association and NBA tiate between foot and ankle injuries for the masters’
six-season retrospective study, Deitch et al24 concluded category. In that category, only one study and a small
that the lower limbs (65%) were the most common site number of injuries were found compared with the
of injury in basketball. Of the 5272 injuries of the profes- other categories. The percentages in knee and ankle
sional category included in this study, 3411 occurred in injuries varied between the sexes and the levels of sport,
the lower limbs, representing 64.7% of the total injuries making it difficult to affirm which is the most prevalent,
reported. as previously described.
According to the specific anatomical region, the largest Both knee and ankle injuries are the most prevalent.
proportion of injuries occurred in the ankle (2832 inju- As shown by the inferential analysis and the OR values
ries, 21.9%), followed by the knee (2305 injuries, 17.8%). (table 3), which uses knee injuries as a reference and
Most authors point to the ankle as the most common site compares it with the other anatomical regions cate-
of injury13 14 31–34; however, some authors report that the gorised in this study, the probability of knee injury
knee is the most affected region.35 36 occurring is higher than that of all regions except for the
When analysed separately, 19.5% of injuries occurred ankle and foot, which is statistically significant because in
in the ankle and 20.6% in the knee in females, whereas all comparisons p was <0.001.

Table 3  Estimated values of OR compared with knee injuries, limits of the 95% CI and p value for the hypothesis of OR=1
Local OR Lower limit (95% CI) Upper limit (95% CI) P value

Ankle and foot 0.4625 0.4365 0.4900 <0.0001

Thigh, hip and leg 1.3590 1.2701 1.4541 <0.0001
Head and neck 1.6838 1.5697 1.8062 <0.0001
Trunk and spine 2.6710 2.4669 2.8920 <0.0001
Shoulder, arm and forearm 4.6028 4.1880 5.0586 <0.0001
Hands, fingers and fist 2.2531 2.0891 2.4300 <0.0001
Other (except previous ones) 4.7209 4.2898 5.1954 <0.0001

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Because basketball is a sport that involves sudden adolescents categories, with 437 and 1024 injuries, respec-
changes in direction, side shifts, jumps, and more impor- tively. Proportionally, in relation to the total number of
tantly landings, these results are not surprising. It would injuries reported by each category, these numbers repre-
be logical and expected that injuries in the lower limbs sent 62% and 38% of injuries in children and adolescents
would be the most prevalent.8 and adults, respectively. Therefore, there is a tendency for
With regard to upper limb injuries, injuries to the children and adolescents to suffer more head and neck
hands, fingers and wrists (1133, 8.7%) predominated injuries than those in the professional category. There is
over shoulder, arm and forearm injuries (585, 4.5%).37 also a study showing that this is a trend in teenage male
This was observed in all categories analysed: for females, basketball players because of the increase in the level of
hands, fingers and wrists represented 8.6% (369) of inju- physical contact now observed among players of this cate-
ries, and shoulders, arms and forearms represented 4.2% gory.31
(182) of injuries; for males, hands, fingers and wrists A total of 975 injuries occurred in the trunk and spine,
represented 8.4% (386) of injuries, and shoulders, arms representing 7.5% of all injuries. Of these 975 injuries,
and forearms represented 5.8% (267) of injuries. For the only 371 occurred in children and adolescents, and 586
age/level of skill categories, the data were similar except occurred in professionals. Of the total trunk and spine
for the masters’ category, which presented essentially the injuries reported, 31% and 69% occurred in children
same number of injuries in the hands, fingers and wrists, and adolescents and professionals, respectively. A higher
and in the shoulder, arm and forearm. However, for this prevalence of trunk and spine injuries was observed in
category, only one study and a small number of injuries professionals.
were reported. For children and adolescents, injuries in Only 5% of all injuries reported for children and adoles-
the hands, fingers and wrists represented 8.9% (662) of cents occurred in the trunk and spine. For professionals,
injuries, and injuries in the shoulders, arms and forearms this number was 11.1%. According to Starkey33 in a study
represented 3.2% (238) of injuries. For professionals, on NBA players, only 6.9% of all injuries occurred in this
injuries in the hands, fingers and wrists represented 8.6% region; however, only injuries to the lumbar and thoracic
(454) of injuries, and injuries in the shoulder, arm and spine were counted, and other injuries that occurred in
forearm represented 6.2% (328) of injuries. For masters, the trunk were not considered. This fact could explain
injuries in the hands, fingers and wrists represented 7.1% the observed difference between the values reproduced
(17) of injuries, and injuries in the shoulders, arms and by this study and the study by Starkey.33

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forearms represented 7.9% (19) of injuries. These data Other authors have obtained results for adolescents
are also consistent with the literature, with some studies in which trunk and spine injuries account for 11.4% to
reporting 12%–14% of injuries occurring in the upper 13.5% of all injuries.31 32 In this study, there was not a
limbs.33 38 category for adolescents only, which could explain the
The percentage of injuries in the upper limbs increases difference in results: adolescents may have a greater
when the sample is obtained from emergency depart- proportion of injuries in the trunk and spine compared
ments, as reported by the studies.39 40 When hand, finger with the group of children and adolescents together.
and wrist injuries were analysed separately among chil- Because adolescence is an intermediary phase between
dren and adolescents and professionals, 662 injuries the child and the adult phases, it seems logical that adoles-
occurred in children and adolescents and 454 occurred cents have a higher spinal injury rate than children. The
in professionals. These numbers represent 50.81% and trunk and spine was the fourth most prevalent injury
49.19% of all injuries in children and adolescents and region in professionals. For the masters’ category, only
professionals, respectively. Therefore, for these catego- 18 trunk and spine injuries were reported; this number
ries, the probability of injury to the hands, fingers and is very small compared with the other categories. Again,
wrists is the same. this occurred because there was only one study reporting
Considering the importance of the increase in the injuries in the masters’ category.
diagnosis of concussions, a brief analysis of the injuries in
this anatomical region is valid, although combined with Limitations of the study
neck injuries. In total, there were 1468 injuries in this Among the existing limitations is the fact that after
region, representing 11.3% of total injuries. In females, applying the search strategy, only one study was found in
417 injuries (9.7%) occurred in this region, and in males the masters’ category and it included only male athletes,
384 injuries (8.3%) occurred in this region. Because in accounting for a total of 239 injuries. In addition, only
some studies it was not possible to differentiate injuries one study in the children category was also found, with
by sex, the sum of injuries between males and females only 84 injuries in 162 female athletes. For the descrip-
was not equal to the total injuries reported. The value tive statistics of the injuries, the study with children was
reported by the studies for the injuries in these anatom- included along with the adolescents’ category, resulting
ical regions varied between 8.9% and 14%.24 31–33 in 7449 injuries among children and adolescents.
Excluding the masters’ class, which had a much smaller Another limitation was the set-up of the database:
number of reported injuries, head and neck injuries were because each study used a standard to divide the inju-
compared between the professional and children and ries between the various parts of the body, some regions

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