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Sport and recreation-related injuries and fracture occurrence among emergency department attendees: implications for exercise prescription and injury prevention
  1. E C Falvey1,
  2. J Eustace3,
  3. B Whelan1,
  4. M S Molloy2,
  5. S P Cusack2,
  6. F Shanahan1,
  7. M G Molloy1
  1. 1
    Department of Medicine, Cork University Hospital, Wilton, Cork, Ireland
  2. 2
    Department of Emergency Medicine, Cork University Hospital, Wilton, Cork, Ireland
  3. 3
    Department of Clinical Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  1. Dr E C Falvey, Department of Rheumatology, Sports and Exercise Medicine, Cork University Hospital, Wilton, Cork, Ireland; e.falvey{at}


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 recreation-related 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 lower-limb 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 high-risk 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.

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  • Funding: The study was funded from clinical revenues by the Department of Rheumatology, Sports and Exercise Medicine Programme, Cork University Hospital, Cork, Ireland. The corresponding author (ECF) was funded by the Irish Centre for Arthritis Research and Education. These sources of funding had no role in the study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the article for publication.

  • Competing interests: None.

  • Ethics approval: Ethics approval was secured from the Cork Teaching Hospitals Ethics Committee.