Pediatric and adolescent sports injuries

Twenty-five million scholastic and 20 million organized, community-based athletes are estimated to participate in sports annually in the United States. Additional sport exposure occurs during unsupervised free play. With this volume of activity, injury exposure is significant. Three quarters of a million sports-related injuries in patients under 15 years of age are seen in US emergency rooms annually. Because a significant number of injuries are managed in homes, offices, and clinics, especially nonacute injuries, the true incidence and prevalence of sports injuries in this age group are unknown. Estimates have been that up to 20% of participants sustain an injury. Of these injuries, most (80%) are minor contusions, abrasions, and lacerations with few subsequent sequelae. About 20% to 25% of the acute injuries are considered serious. Despite these daunting numbers, school age sports are, overall, quite safe. Injury rates and severity are age and sport specific. Collision sports in high school age students at high levels of competition, not surprisingly, have the highest number of significant injuries. injury rates and severity are proportionally less at junior and middle school age levels. Pediatric and adolescent athletes are unique because of their growth potential and its effects. Maturation is very variable in its onset, rate, magnitude, and duration. This is especially true during the physiologic ''never-never land'' of adolescence. Junctional tissues (physes, muscle-bone, tendon-bone) are targets for hostile tensile, compressive, and shear stresses. Girls mature earlier than boys, but until age 8 or 9 years, boys and girls have equal strength and endurance and can compete as equals on coed teams. Two varieties of injury types occur: (1) as sequelae of acute trauma, and (2) as the result of repetitive microtrauma, the so called ''overuse injury.'' This article focuses on common problems associated with each type of these injuries in the skeletally immature athlete.