The Epidemiology of Sports and Recreation Related Toe Fractures in the United States
Background: Fractures of the toes are among the most frequently diagnosed lower extremity fractures. In sports, toe fractures may present after diverse mechanisms of injury, varying severity, and varying implications for management. This study aimed to discern trends in toe fractures presenting to U...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2025-06-01
|
| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114251342797 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849433269941043200 |
|---|---|
| author | Dogerno Norceide BS Gabriel I. Onor MD Oluwatomi Akingbola MD William Justice MD Nana F. Amponsah BS Abimbola Okulaja MD Ifeanyichukwu Onor PharmD Michael Okoronkwo MD Chibuikem Nwizu BS David Pedowitz MD |
| author_facet | Dogerno Norceide BS Gabriel I. Onor MD Oluwatomi Akingbola MD William Justice MD Nana F. Amponsah BS Abimbola Okulaja MD Ifeanyichukwu Onor PharmD Michael Okoronkwo MD Chibuikem Nwizu BS David Pedowitz MD |
| author_sort | Dogerno Norceide BS |
| collection | DOAJ |
| description | Background: Fractures of the toes are among the most frequently diagnosed lower extremity fractures. In sports, toe fractures may present after diverse mechanisms of injury, varying severity, and varying implications for management. This study aimed to discern trends in toe fractures presenting to US emergency departments (EDs) particularly in association with sports and recreational activities. An additional aim of the study was to identify if rates of toe fracture presentation significantly decreased during the year 2020 at the height of the COVID-19 pandemic. Methods: We queried the National Electronic Injury Surveillance System (NEISS) database to identify toe fractures presented to US EDs from 2013 to 2022. The data outputs were analyzed by age group, sex, sport/recreational activity, and year. US Census data were used for calculation of incidence rates (IR) in 100,000 person-years. χ 2 tests and regression analyses were performed to determine significance. Grubbs’s test was performed to determine significant yearly outliers with particular attention to the year 2020. Results: A total of 921,033 toe fractures were identified across US EDs, with 175,864 cases associated with sports and recreation. Exercise (IR = 140.3) had the leading IR among sports/recreation followed by cycling (IR = 136.8), basketball (IR = 136.8), and football (IR = 94.9). Males accounted for 40.8% of fractures (IR = 23.0), whereas females contributed 59.2% (IR = 32.8). Toe fractures peaked in the 10- to 14-year-old age group in both males and females. Sports- and recreation-related toe fractures did not significantly decrease from 2013 to 2022, although all-cause toe fractures did significantly decrease as shown by a P value of .0037 from linear regression analysis of yearly trend in all toe fractures. The year 2020 was a significant outlier with a decrease in sports-related toe fractures though there was no significant decrease in all-cause toe fractures in 2020. Conclusion: Sports- and recreation-related toe fractures did not significantly decrease from 2013 to 2022, although a significant decrease in all-cause toe fractures was observed. Toe fractures continue to peak in the pediatric age groups, particularly 10-14 year-olds. Youth sports and recreation officials should be aware of the risks of toe fractures to aid in prevention. Level of Evidence: Level III, epidemiologic database, retrospective cohort studies. |
| format | Article |
| id | doaj-art-1c6876bbc72249e5a5fb5968d61ca4e0 |
| institution | Kabale University |
| issn | 2473-0114 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj-art-1c6876bbc72249e5a5fb5968d61ca4e02025-08-20T03:27:07ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142025-06-011010.1177/24730114251342797The Epidemiology of Sports and Recreation Related Toe Fractures in the United StatesDogerno Norceide BS0Gabriel I. Onor MD1Oluwatomi Akingbola MD2William Justice MD3Nana F. Amponsah BS4Abimbola Okulaja MD5Ifeanyichukwu Onor PharmD6Michael Okoronkwo MD7Chibuikem Nwizu BS8David Pedowitz MD9Drexel University College of Medicine, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USADepartment of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USARothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USACrozer Chester Medical Center, USALouisiana State University School of Medicine, New Orleans, LA, USALouisiana State University School of Medicine, New Orleans, LA, USAWarren Alpert Medical School, Brown University, Providence, RI, USARothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USABackground: Fractures of the toes are among the most frequently diagnosed lower extremity fractures. In sports, toe fractures may present after diverse mechanisms of injury, varying severity, and varying implications for management. This study aimed to discern trends in toe fractures presenting to US emergency departments (EDs) particularly in association with sports and recreational activities. An additional aim of the study was to identify if rates of toe fracture presentation significantly decreased during the year 2020 at the height of the COVID-19 pandemic. Methods: We queried the National Electronic Injury Surveillance System (NEISS) database to identify toe fractures presented to US EDs from 2013 to 2022. The data outputs were analyzed by age group, sex, sport/recreational activity, and year. US Census data were used for calculation of incidence rates (IR) in 100,000 person-years. χ 2 tests and regression analyses were performed to determine significance. Grubbs’s test was performed to determine significant yearly outliers with particular attention to the year 2020. Results: A total of 921,033 toe fractures were identified across US EDs, with 175,864 cases associated with sports and recreation. Exercise (IR = 140.3) had the leading IR among sports/recreation followed by cycling (IR = 136.8), basketball (IR = 136.8), and football (IR = 94.9). Males accounted for 40.8% of fractures (IR = 23.0), whereas females contributed 59.2% (IR = 32.8). Toe fractures peaked in the 10- to 14-year-old age group in both males and females. Sports- and recreation-related toe fractures did not significantly decrease from 2013 to 2022, although all-cause toe fractures did significantly decrease as shown by a P value of .0037 from linear regression analysis of yearly trend in all toe fractures. The year 2020 was a significant outlier with a decrease in sports-related toe fractures though there was no significant decrease in all-cause toe fractures in 2020. Conclusion: Sports- and recreation-related toe fractures did not significantly decrease from 2013 to 2022, although a significant decrease in all-cause toe fractures was observed. Toe fractures continue to peak in the pediatric age groups, particularly 10-14 year-olds. Youth sports and recreation officials should be aware of the risks of toe fractures to aid in prevention. Level of Evidence: Level III, epidemiologic database, retrospective cohort studies.https://doi.org/10.1177/24730114251342797 |
| spellingShingle | Dogerno Norceide BS Gabriel I. Onor MD Oluwatomi Akingbola MD William Justice MD Nana F. Amponsah BS Abimbola Okulaja MD Ifeanyichukwu Onor PharmD Michael Okoronkwo MD Chibuikem Nwizu BS David Pedowitz MD The Epidemiology of Sports and Recreation Related Toe Fractures in the United States Foot & Ankle Orthopaedics |
| title | The Epidemiology of Sports and Recreation Related Toe Fractures in the United States |
| title_full | The Epidemiology of Sports and Recreation Related Toe Fractures in the United States |
| title_fullStr | The Epidemiology of Sports and Recreation Related Toe Fractures in the United States |
| title_full_unstemmed | The Epidemiology of Sports and Recreation Related Toe Fractures in the United States |
| title_short | The Epidemiology of Sports and Recreation Related Toe Fractures in the United States |
| title_sort | epidemiology of sports and recreation related toe fractures in the united states |
| url | https://doi.org/10.1177/24730114251342797 |
| work_keys_str_mv | AT dogernonorceidebs theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT gabrielionormd theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT oluwatomiakingbolamd theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT williamjusticemd theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT nanafamponsahbs theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT abimbolaokulajamd theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT ifeanyichukwuonorpharmd theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT michaelokoronkwomd theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT chibuikemnwizubs theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT davidpedowitzmd theepidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT dogernonorceidebs epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT gabrielionormd epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT oluwatomiakingbolamd epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT williamjusticemd epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT nanafamponsahbs epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT abimbolaokulajamd epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT ifeanyichukwuonorpharmd epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT michaelokoronkwomd epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT chibuikemnwizubs epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates AT davidpedowitzmd epidemiologyofsportsandrecreationrelatedtoefracturesintheunitedstates |