Trends in Pediatric Skateboard Related Foot and Ankle Injuries Presented to US Emergency Departments from 2009-2018: A Descriptive Epidemiology Study

Abstract

Category: Ankle; Sports; Trauma; Other Introduction/Purpose: Skateboarding has been a part of American culture since its origins in the 1960s. ESPN’s X Games debuted in the 90s and popularity soared. In 1996, there were an estimated 5.8 millions children that participated in the sports with some 750,000 involved weekly. In 1999, there was approximately 51,000 pediatric skateboard related injuries seen in United States emergency rooms. Most injuries happen when the skateboard comes into contact with irregularities in the riding surface. A previous study showed that from 1987-1998, ankle sprains/strains were the most common injury seen in the emergency department (ED). The purpose of this study is to examine the updated trends of skateboard related foot and ankle injuries (SFA) from the years 2009 to 2018. Methods: Data was obtained from the National Electronic Injury Surveillance System (NEISS). Injury data is obtained daily from the emergency departments of approximately 100 hospitals across the United States and its territories. This serves as a probability sample of over 5000 hospitals across the country. Each case recorded is given a statistical weight based on the study design. CPSC analysis has the ability to make adjustments to more accurately represent the entire U.S. population. Hospitals are grouped into five strata mostly based on hospital size and number of ED visits they receive per year. The database was set with query inputs of patients aged 2-17 that presented to the ED with skateboard related lower leg, ankle, or foot (fracture and/or sprain. Time period queried was between January 1, 2009 to December 31, 2018. Results: An estimated total of 107,712 pediatric patients had a SFA injury between 2009-2018. With a mean age of 13.8 years. There was approximately 644,030 total skateboard related injuries. SFA injuries accounted 18.4 % in 2010 and 14.8 % in 2018. There was an estimated total of 4,263,682 foot and ankle sprains and/or fracture, of which 3.4% were SFA in 2010. The annual rate of injury per 100,000 children has decreased 72.1% from 23.3 to 6.5. Skateboard participation was approximately 7.35 millions riders above the age of 6 in the U.S in 2009, this number has declined 12.4% to 6.44 in 2016 with the lowest year being 2011 at 5.83 million. Since 2012 to 2016 this participation figure has ranged from 6.35 – 6.63 million. Conclusion: The decline in the number of participants in the sport has been far outpaced by the decline in injuries being seen in the ED. For the time period of this study, the style and structure of the footwear have not varied significantly. A study showed that shoe height did not change ankle inversion angle. Another possible factor is increase urgent care usage. The number of centers has increased 43.8% from 2013 to 2018. In 2016 these centers saw 4% of all their claims be sprains or strains. Further research is needed to trend data for other points of care.