Sport and recreation-related injuries and fracture occurrence among emergency department attendees: Implications for exercise prescription and injury prevention

Objective: To investigate the epidemiology of sports and recreation-related injury (SRI) among emergency department (ED) attendees. Design: Descriptive epidemiology study. Setting: An Irish university hospital ED. Participants: All patients aged over 4 years attending a large regional ED, during a 6-month period, for the treatment of SRI were prospectively surveyed. Assessment of Risk Factors: In all cases identified as SRI the attending physician completed a specifically designed questionnaire. It was postulated that recreationrelated injury is a significant proportion of reported SRI. Results: Fracture rate was highest in the 4-9-year age group (44%). On multivariate logistic regression the adjusted odds ratio (OR; 95% CI) of fracture was higher for children (vs adults) at 1.21 (1.0 to 1.45). The adjusted OR was higher for upper-limb 5.8 (4.5 to 7.6) and lowerlimb injuries 1.87 (1.4 to 2.5) versus axial site of injury and for falls 2.2 (1.6 to 2.9) and external force 1.59 (1.2 to 2.1) versus an overextension mechanism of injury. In the same model, "play" was independently associated with fracture risk, adjusted OR 1.98 (1.2 to 3.0; p=0.001) versus low-risk ball sports 1.0 (reference); an effect size similar to that seen for combat sports 1.96 (1.2 to 3.3; p=0.01) and greater than that seen for presumed highrisk field sports 1.4 (0.9 to 2.0) Conclusion: Fall and subsequent upper-limb injury was the commonest mechanism underlying SRI fracture. Domestic "play" in all age groups at the time of injury accorded a higher fracture risk than field sports. Patient education regarding the dangers of unsupervised play and recreation represents a means of reducing the burden of SRI.