Craniomaxillofacial injuries from the sport of wrestling: a query of the National Electronic Injury Surveillance System (NEISS)

The purpose of this study was to provide a novel report on the head and neck injuries from the sport of wrestling and their characteristics in the USA.

This is a 20-year retrospective cross-sectional study conducted using the National Electronic Injury Surveillance System (NEISS). Reports were included in the analysis if the injury stemmed from combat with another person. The predictor variables were obtained from both patient and injury characteristics. The principal outcome variable was admission rate, which was used to proxy the severity of the injury at hand. Bivariate analysis (i.e., chi-square and independent sample tests) was used to determine if an association existed between two variables of interest.

The final sample in our study consisted of 4485 cases of craniomaxillofacial injuries secondary to wrestling. The increase in injuries from the year 2000 to 2019 was significant (P < 0.05). The average age of patients was 15.73 (range: 3 to 59 years old). Virtually all of the injuries occurred in males (95.6%). The majority of patients was under the age of 18 (82.3%). With regard to race, white wrestlers (57.1%) comprised the majority of patients. Insight into race was not available for 1245 patients (27.8%). Most wrestling-related injuries took place during the winter season (60.6%). Concussion was the most common primary diagnosis (29.0%). The head (57.1%) was the most commonly injured craniomaxillofacial region. The most common setting in which the injury took place was a place of recreation/sports (49.9%). Among the mechanisms of injuries, the take-down (26.5%) was the most common. Patients who were thrown/taken down (5.04%) were significantly more likely to get admitted (P < 0.01) relative to patients who were injured otherwise (2.6%). Similarly, patients who fell/tripped (6.6%) were significantly more likely to get admitted (P < 0.05) relative to patients who were injured otherwise (3.1%). While cases of concussion (6.0%) were significantly more likely to get admitted (P < 0.01) relative to other cases, cases of contusions/abrasions (0.6%) were significantly less likely to get admitted (P < 0.01) relative to other cases. Similar to contusions/abrasions (0.2%), lacerations were significantly less likely to get admitted (P < 0.01) relative to other cases. Patients aged 12–18 (P < 0.01) were most likely to suffer concussions, whereas patients aged 19–34 (P < 0.01) were least likely to suffer concussions. In contrast to concussions, patients aged 12–18 (P < 0.01) were least likely to suffer lacerations, whereas patients aged 19–34 (P < 0.01) were most likely to suffer lacerations. Patients aged 6–11 (P < 0.01) were most likely to be thrown/taken-down whereas patients aged 19–34 (P < 0.01) were least likely to be thrown. Patients aged 19–34 (P < 0.01) were most likely to be collided against intentionally, while patients aged 6–11 (P < 0.01) were least likely to be collided against intentionally. Patients aged 34 years or older were most likely to fall/trip, while patients aged 12–18 (P < 0.01) were least likely to fall/trip.

Certain types of injuries that occur during wrestling are more or less common depending on the age groups involved in the sport. Concussions were the most common injury incurred overall, and the head is the most commonly affected craniomaxillofacial area. Take-downs were the most likely mechanism of injury to lead to hospital admissions. The average number of wrestling injuries increased over 20 years being analyzed in this study. Future studies should investigate methods to lessen concussions in wrestling, decrease the number of illegal moves performed, and look into ways to mitigate harm from take-downs, given the increasing number of injuries acquired from this sport.