Injury. 2025 Dec 4;57(2):112929. doi: 10.1016/j.injury.2025.112929. Online ahead of print.
BACKGROUND: Musculoskeletal injuries occur in various school-based settings. However, no information describes musculoskeletal injury risk in school-aged populations relative to age, race, season, body part, and injury classification. We sought to perform an epidemiological analysis and create estimated multinomial logistic regression (MLR) models to profile school-based musculoskeletal injuries seen and treated at United States emergency departments from 2019 through 2023.
METHODS: We retrospectively searched the National Electronic Injury Surveillance System (NEISS) database from the United States Consumer Product Safety Commission (CPSC) between 2019 and 2023 for all school-based injuries in patients between 5 and 18 years of age. Through relative risk ratio calculations and MLR modeling, we created a comprehensive epidemiological analysis and predictive risk assessment profile of school-based musculoskeletal injuries between 2019 and 2023.
RESULTS: School-based musculoskeletal injuries declined during the 3-year COVID-19 timeframe and returned to above pre-COVID levels during 2023. Middle school-aged students experienced the most injuries, with high school students experiencing the least. A total of 54.6 % of injuries were to the upper extremity, with 38.5 % of injuries occurring in the lower extremity and 6.9 % in the trunk. Our estimated MLR models indicated that the most at-risk males for school-based musculoskeletal injuries were elementary students for upper and lower arm, wrist, and finger fractures during the summer, while middle and high school females demonstrated the highest risk of sustaining strains/sprains to the wrist and ankle during the summer and winter months.
CONCLUSIONS: From the NEISS database, we described the prevalence estimations of school-based musculoskeletal injuries reported to and treated by the United States emergency departments from 2019 through 2023. With our estimated MLR models, teachers, staff, school districts, administrators, healthcare providers, and other school leaders could create education and supervision initiatives to help prevent musculoskeletal injuries sustained in school settings.
PubMed:41370958 | DOI:10.1016/j.injury.2025.112929