lnjuries in wrestling: systematic review.

OBJECTIVES: To identify all studies of injuries in wrestling, assess risk of bias and compute weighted average injury rates.

METHODS: 17 online databases and nine grey literature resources were searched with no language/date limitations. Abstracts were assessed for inclusion and data abstracted independently by two reviewers.

RESULTS: Eleven studies of competitions, 27 databases, four surveys (699 wrestlers) and seventeen case reports (604 cases) were included. Studies provided varying completeness of data. Weighted average injury rates of 16.3/1000AE (AE = Athletic encounter) could be computed for 8/11 studies of competitions and 69.5/1000AE for 5/27 databases. Eleven of the databases focused on specific injuries. Weighted average injury rates by location for 8/11 competition studies and 7/16 databases were similar for the upper extremities (competitions 26%, databases 24%) and torso (15%, 12%), but dissimilar for head/neck (31%, 20%) and lower extremities (24%, 39%). Weighted average injury rates by injury type varied from 6/11 to 2/11 competition studies and 6/16 to 3/16 database studies. Percentages were similar for fractures (6%, 7%), dislocations/subluxations (6%, 6%), ligament tears/cartilage injuries (12%, 17%) and concussions/1000AE (2 competition studies, 1 database) in competitions (25%, 27%) and training (5.7%, 7.1%). Percentages were dissimilar for lacerations/abrasions/contusions (23%, 4%) and sprains/strains (38%, 26%). The differences may be due to the small number of databases providing specific data and the unknown proportion of training injuries. Databases extrapolating injuries to the national US level reported high annual numbers.

CONCLUSIONS: Average injury rates weighted by sample size are 16.3/1000AE for 8/11 competition studies and 69.5/1000AE for 5/27 databases. Competition data are likely to be accurate because they were observed by physicians, trainers and referees and the completeness and accuracy of database studies vary. Databases which extrapolated data to provide annual national rates estimated large numbers. Few studies provided data about the situations in which injuries occur and the causes of injuries.