Upper Extremity Neurovascular Injuries in Collegiate Athletes: Sex, Race, and Return to Sport

TL;DR

This study examines upper extremity neurovascular injuries in collegiate athletes, finding that most are temporary and athletes often return to their sport.

Contribution

This is the first study to report on the sex and race distribution of upper extremity neurovascular injuries in collegiate athletes.

Findings

Most UENVIs are transient and self-limited with high return to sport rates.

Female athletes had a higher incidence of UENVIs when football players were excluded.

Wrestling, football, and tennis had the highest UENVI rates.

Abstract

Upper extremity neurovascular injuries (UENVIs) are a significant yet understudied aspect of sports medicine. Although distinct UENVIs have been independently studied, no report describes the incidence of UENVIs across all collegiate sports.

To analyze the occurrence, demographics, treatment modalities, and outcomes associated with UENVIs across various sports in collegiate athletes using data from the Pac-12 Health Analytics Program database.

Case series; Level of evidence, 4.

The Pac-12 Health Analytics Program database was queried for brachial plexus injuries and sports-related UENVIs over a 7-year period (2016-2022). UENVIs were subdivided into neurologic neck injury, transient brachial plexus injury, and thoracic outlet syndrome. Statistical analysis consisted of the chi-square test for categorical variables and analysis of variance for continuous variables. Significance was defined as P < .05.

In total, 15,609 athletes with injuries across 21 sports were identified, of whom 213 experienced UENVIs. Of the athletes, 155 (72.8%) were male and 58 (27.2%) were female. Football players comprised the largest number of UENVI cases. When football players were excluded from the analysis, female athletes had a higher incidence of UENVIs at 61.7% compared to males at 38.3%. Most players were White (50.8%) or Black (23%). Among all athletes in each sport, the highest rates of UENVIs were observed in wrestling (3.9%), football (3.6%), and tennis (2.6%). Of the athletes, 95.5% with UENVIs returned to their previous level of activity or reported no interference with their sport from the injury.

Most UENVIs in collegiate athletes are transient and self-limited. This is the first study to report on sex and race distribution for UENVIs. Many athletes return to sport at a similar or higher level.

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