Epidemiology of Contact and Non-Contact Ankle Injuries in Collegiate Athletes

CATEGORY: Ankle, Sports INTRODUCTION/PURPOSE: Ankle injuries can often have profound implication in the potential careers of National Collegiate Athletic Association (NCAA) athletes. Accordingly, a more thorough characterization of these injuries and insight into injury etiology is warranted. In addition, a more comprehensive understanding will allow proper education of athletes when injuries do occur. Here we review the incidence and effect of ankle injuries on NCAA athletes and their athletic season. METHODS: Ankle injuries across 16 collegiate sports played by men and women from 2004-05 to 2013-14 academic years were surveyed from the NCAA Injury Surveillance Program (NCAA-ISP). Ankle injury rates per 10,000 athlete-exposures (IR), operative rate, annual injury rate trends, re-injury rates, in-season status (pre/in/post-season) at time of injury, and time loss distributions were perused. In effort to include both male and female atheletes equally, a sub-group analysis of contact sports played by both genders (C-BG) was performed to determine if there was a significant difference in risk when compared to those athletes that did not play contact sports. These sports included basketball, soccer, lacrosse, and ice hockey. Types of ankle injuries (soft tissues or bony) were also sub-classified and counted. RESULTS: Over the course of 10 years, there were 14,080 ankle injures identified (IR=11.9). There were 8,978 (IR=12.1) injuries in males and 5,102 (IR=11.7) injuries in females. The rate of injuries that occurred in C-BG cohort (IR=14.5) was greater than that of the total group of noncontact participants (IR=7.6). When comparing injury rates between all contact sports(IR=14.1) and all noncontact sports (IR=7.6) the difference was found to be statistically significant(p <0 .0001). In the C-BG group, 1.4% of injuries were operative (N=93). The overall mean time loss for C-BG was 10.9 days when excluding patients who had season ending injuries. Across all atheletes, the top three contact sports with season ending ankle injuries were football, basketball, and lacrosse. Importantly,16.8% of all injuries were classified as re-injuries. CONCLUSION: Ankle injuries represent a common and broad spectrum of injuries in collegiate athletes. A majority of ankle injuries occurred during the regular season with sprains, strains, contusions, and fractures representing the most common types of injuries. Contact sports tend to have higher rates of ankle injuries than noncontact sports. As the consequence of index ankle injury appears to be higher predisposition to reinjury, a better understanding of the kinds of ankle injuries and their respective causes may help elucidate trends useful in the development of various prevention strategies.