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Abstract & Commentary
Synopsis: Injuries that occur in youngsters participating in baseball are frequent but generally not severe.
Source: Mueller FO, et al. The Physician and Sports Medicine. 2001;29(7):41-48.
In the thorough style that is typical of this superb sports epidemiologist, Dr. Frederick Mueller and his colleagues present a statistical analysis of little league baseball injuries. Players between the ages of 5 and 12 were analyzed over a 10-year period from 1987 through 1996 during which an estimated 1,722,121 children participated each year. Data was obtained from analysis of compensated insurance claims filed with little league baseball. While some may view this means of collecting injury data as a limitation of the study, Mueller et al, after their careful review, state that, "these insurance claims data provide a valid and comprehensive picture of injury in little league baseball."
During the study, 29,038 injuries occurred with an injury rate of 1.69 injuries per 1000 participants per season. Approximately 25% of the injuries were considered severe, and 13 players died. Mueller et al present their data in easy to review tables. The tables detail injuries per player position resulting from ball-related trauma; sliding, running, or tagging; and colliding, falling, or being hit by the bat. A table detailing the mechanism of the 13 fatalities is also provided, as is a table relaying the incidence of each injury type (eg, fracture, dislocation, laceration, contusion) per body part.
Finally, Mueller et al have emphasized that data such as theirs are most helpful when analyzed to help develop injury prevention strategies, and, based on their data, they make recommendations along these lines.
COMMENT BY LETHA Y. GRIFFIN, MD, PhD
Mueller et al state that next to basketball, baseball is the most commonly played team sport in this country with approximately 8.6 million 6- to 17-year-olds parti-cipating each year. Hence, it is prudent to analyze not only the incidence of injury, but the type of injuries and the mechanisms of injury seen in those playing this sport. Surprisingly, of the 216 ball-related chest injuries reported in this study, none resulted in death. Ball-related chest trauma resulting in death from commotio cordis, an arrhythmia (generally ventricular fibrillation), or sudden death from low impact, blunt trauma to the chest without apparent heart injury has been reported in young players and, in fact, is one reason why some have recommended chest protection and softer baseballs for younger players as well as the accessibility of automatic external defibrillators (AEDs) for use by medical personnel covering youth baseball and softball games.1 However, Mueller et al state, following analysis of their data, ". . .there is no evidence that a vest will protect the batter as shown in this study—the number of chest injuries is small."
Mueller et al do feel that since sliding was associated with approximately 60% of the injuries to base runners, that safety bases as previously recommended by Janda and associates would reduce a significant number (approximately 3000) of these injuries.2 Data presented in this article would be helpful not only as background information for coaches, players, and the families of the players, but also for those involved in little league baseball who are responsible for recommendations regarding injury prevention and safety equipment.
1. Vincent GM, McPeak H. The Physician and SportsMedicine. 2000;28(11):31-39.
2. Janda DH, et al. Clin J Sports Med. 1993;3:78-81.