title: Sex and growth effect on pediatric hip injuries presenting to sports medicine clinic.
abstract: To compare sports-related hip injuries on the basis of sex and age in a cohort of young athletes. A 5% random probability sample of all new patients' charts over a 10-year time period was selected for investigation. The most common hip injury diagnoses, sport at time of injury, mechanism (acute/traumatic vs. overuse), and types (bony vs. soft tissue) were compared by sex and age (preadolescent vs. adolescent). Descriptive and χ-analyses were carried out. The interaction of sex and age with respect to hip injury over time was examined by two-way (sex, age) analysis of variance. A total of 2133 charts were reviewed; N=87 hip injuries. The main diagnoses for males included labral tear (23.1%), avulsion fracture (11.5%), slipped capital femoral epiphysis (11.5%), dislocation (7.7%), and tendonitis (7.7%). The main diagnoses for females were labral tear (59.0%), tendonitis (14.8%), snapping hip syndrome (6.6%), strain (4.9%), and bursitis (4.9%). The five most common sports/activities at the time of hip injury were dancing/ballet (23.0%), soccer (18.4%), gymnastics (9.2%), ice hockey (8.1%), and track and field (6.9%). Age by sex comparisons showed a greater proportion of the total hip injuries (38.5%) in males compared with females (8.2%) during preadolescence (5-12 years). However, in adolescence (13-17 years), the hip injury proportion was significantly higher in females (91.8%) compared with males (61.5%; P<0.001). Injury mechanism and type differed by sex, with females sustaining more chronic/overuse (95.1%) and soft tissue type injuries (93.4%) compared with males (50.0 and 53.8%, respectively; P<0.001). Females were found to have a sharper increase in hip injury proportion as they progressed through puberty compared with males (analysis of variance sex-by-age interaction; P<0.001). Hip injury mechanism and type differed significantly between males and females during growth. Notably, the proportion of hip injuries in the young female athletes showed a significantly greater increase with advancing age compared with males. Hip injuries in children and the interplay with growth, as it relates to injury predisposition, require further investigation to facilitate efforts aimed at prevention.
  
  
  METHODS
  Cross-sectional epidemiological study.
authors.affiliation: aThe Micheli Center for Sports Injury Prevention, WalthambDepartment of Orthopedics, Division of Sports MedicinecDepartment of Pediatrics, Division of Emergency Medicine, Boston Children's HospitaldHarvard Medical SchooleDepartment of Physical Therapy & Athletic Training, Boston University, Boston, Massachusetts, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Stracciolini
authors.forename: Yi-Meng
authors.initials: YM
authors.lastname: Yen
authors.forename: Pierre A
authors.initials: PA
authors.lastname: d'Hemecourt
authors.forename: Cara L
authors.initials: CL
authors.lastname: Lewis
authors.forename: Dai
authors.initials: D
authors.lastname: Sugimoto
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D056352:Athletes; D001265:Athletic Injuries / Q000175:diagnosis* / Q000534:rehabilitation; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003615:Dancing / Q000293:injuries; D005260:Female; D006173:Gymnastics; D025981:Hip Injuries / Q000175:diagnosis* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000379:methods*; D012307:Risk Factors; D012737:Sex Factors; D017695:Soft Tissue Injuries; D013177:Sports; D013178:Sports Medicine; D062606:Tertiary Care Centers