title: Catastrophic injuries in pole vaulters: a prospective 9-year follow-up study.
abstract: BACKGROUND
  A prior review of catastrophic pole vaulting injuries from 1982 through 1998 revealed an average of 2.0 injuries per year, with 69% (1.38 per year) of the injuries secondary to athletes landing off the sides or back of the landing pad and 25% (0.5 per year) from athletes landing in the vault box. In 2003, several rule changes for the sport of pole vaulting were mandated, including enlarging the minimum dimensions of the landing pad.
  
  
  OBJECTIVE
  Our goals were to (1) identify the post-2003 rule change incidence and profile of catastrophic pole vaulting injuries through 2011 and compare them, where possible, with the prior incidence and profile and (2) determine, via a questionnaire, the frequency with which pole vaulters land in the vault box. We hypothesized that the new, larger landing pads would reduce the number of catastrophic injuries.
  
  
  METHODS
  Descriptive epidemiology study.
  
  
  METHODS
  We prospectively reviewed all catastrophic pole vaulting injuries (ie, brain hemorrhage; skull, spine, or pelvic fracture; substantial pulmonary or intra-abdominal injury) in the United States from 2003 through 2011, surveyed 3335 pole vaulters to determine the frequency of landing in the vault box, and compared results with those in the literature.
  
  
  RESULTS
  From 2003 to 2011, 19 catastrophic injuries occurred (average of 2.1 per year), with the majority (n = 14, 74%, 1.55 per year) landing in or around the vault box. Four (21%, 0.44 per year) injuries occurred when an athlete landed off the sides or back of the landing pad and 1 (5%) when the pole broke. There were 11 (58%) major head injuries (1 fatality), 4 (21%) spine fractures (1 with paraplegia), 2 (11%) pelvic fractures (both with intra-abdominal injuries), 1 (5%) brain stem injury (fatal), and 1 (5%) thoracic injury (rib fractures and pneumothorax). The annual fatality rate fell from 1.0 in the prior study to 0.22 in the current study. According to the pole vaulters survey, during their careers, 77.12% (n = 2572) landed in the vault box 1 to 3 times, 15.92% (n = 531) never landed in the vault box, 6.12% (n = 204) landed in the vault box 4 to 6 times, and 0.84% (n = 28) landed in the vault box 7 or more times.
  
  
  CONCLUSIONS
  The 2003 rule changes have markedly reduced the number of catastrophic injuries, especially fatalities, from pole vaulters missing the back or sides of the landing pads; however, the average annual rate of catastrophic injuries from pole vaulters landing in the vault box has more than tripled over the past decade and remains a major problem.
authors.affiliation: The Orthopaedic Center, 9420 Key West Avenue, #300, Rockville, MD 20850, USA. bboden@starpower.net
authors.forename: Barry P
authors.initials: BP
authors.lastname: Boden
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Boden
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Peter
authors.forename: Fred O
authors.initials: FO
authors.lastname: Mueller
authors.forename: Jan E
authors.initials: JE
authors.lastname: Johnson
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000517:prevention & control*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008297:Male; D010384:Pelvic Bones / Q000293:injuries; D011446:Prospective Studies; D016103:Spinal Fractures / Q000453:epidemiology* / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D013898:Thoracic Injuries / Q000453:epidemiology / Q000517:prevention & control; D014142:Track and Field / Q000293:injuries*; D014481:United States / Q000453:epidemiology; D055815:Young Adult