title: Epidemiology of syndesmosis injuries in intercollegiate football: incidence and risk factors from National Collegiate Athletic Association injury surveillance system data from 2004-2005 to 2008-2009.
abstract: OBJECTIVE
  To describe the incidence and risk factors for high ankle sprains (ie, syndesmosis injuries) among National Collegiate Athletic Association (NCAA) football players.
  
  
  METHODS
  Descriptive epidemiologic study.
  
  
  METHODS
  Data were examined from the NCAA's Injury Surveillance System (ISS) for 5 football seasons (from 2004-2005 to 2008-2009).
  
  
  METHODS
  All NCAA men's football programs participating in the ISS.
  
  
  METHODS
  No additional risk factors were introduced as a result of this analysis.
  
  
  METHODS
  For partial and complete syndesmosis injuries, outcome measures included incidence, time lost from participation, and requirement for surgical repair.
  
  
  RESULTS
  The overall incidence of high ankle sprains in NCAA football players was 0.24 per 1000 athlete exposures, accounting for 24.6% of all ankle sprains. Athletes were nearly 14 times more likely to sustain the injury during games compared with practice; complete syndesmosis injuries resulted in significantly greater time lost compared with partial injuries (31.3 vs 15.8 days). Less than 3% of syndesmosis injuries required surgical intervention. There was a significantly higher injury incidence on artificial surfaces compared with natural grass. The majority of injuries (75.2%) occurred during contact with another player.
  
  
  CONCLUSIONS
  Our data suggest a significantly higher incidence of syndesmosis injuries during games, during running plays, and to running backs and interior defensive linemen. The wide range in time lost from participation for complete syndesmosis injuries underscores the need for improved understanding of injury mechanism and classification of injury severity such that prevention, safe return to play protocols, and outcomes can be further improved.
authors: Department of Orthopaedic Surgery, Stanford University, Redwood City, CA 94063, USA. kjhunt@stanford.edu
authors: Kenneth J
authors: KJ
authors: Hunt
authors: Elizabeth
authors: E
authors: George
authors: Alex H S
authors: AH
authors: Harris
authors: Jason L
authors: JL
authors: Dragoo
mesh_terms: D016512:Ankle Injuries / Q000453:epidemiology*; D005538:Football / Q000293:injuries*; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult