P3.257: The Price of the Punch: Trends in Child and Adolescent Martial Arts Injuries from the PHIS Database from 2009-2024

Background: Martial arts, including disciplines such as karate, taekwondo, judo, and Brazilian jiu jitsu, have grown in popularity in the United States. Characterization of martial arts-related injuries between different age groups and sexes have yielded inconsistent findings and have not been well-explored in the pediatric population. The primary goal of this study is to describe trends in martial arts-related injuries in athletes ≤17 years of age recorded in the Pediatric Health Information System (PHIS) database from 2010 to 2023 and to describe differences in injury patterns between age, sex, and geographic regions in the United States (U.S.) We hypothesize that rates of martial arts-related injuries will have increased over time, with differences in injury patterns based on age category and sex.

Methods: We queried the PHIS database for patients who presented with martial arts-related injuries among patients ≥3 and ≤17 years old. Unadjusted and mixed-effects logistic regression analyses were performed to identify trends in injury patterns and relationship between age category, sex, anatomic location of injury, type of injury, and location of presentation.

Results: A query of the PHIS database identified 6,823 patients, one-third female (n=2,369; 34.7%), mean age 10.9 ± 3.5 years, with martial arts-related injuries presenting to inpatient hospitals, emergency departments, and ambulatory surgery centers. Injuries were most common in the West (n=2,272; 33.3%) and least common in the Northeast (n=768; 11.3%). Upper extremity injuries were most common (n=3,855; 57.8%), and most injuries were fractures/dislocations/subluxations (n=4,723; 69.2%). Relative to the lower extremity, injuries of the pelvis/hip were more likely to occur in females compared to males (OR 4.24, p=0.001), and females were 61% less likely to sustain a sprain/strain relative to a fracture compared to males (OR 0.39, p< 0.001).

Conclusion: Patterns of martial arts-related injuries vary by patient sex and geographic region. Knowledge of injury patterns may inform the structure of youth martial arts programs and participants’ families of injury risks.