HEAD, NECK, AND FACIAL INJURIES IN ICE HOCKEY - THE EFFECT OF PROTECTIVE EQUIPMENT

Objectives: To determine the factors and behaviors associated with fac ial, head, and/or neck injuries to those engaged in ice hockey; the us e of protective equipment was also examined. Design: Prospective case series. Setting: Emergency Department of Sudbury General Hospital. Pat ients: All patients presenting to the emergency department with a head , neck, or facial injury while playing hockey between the months of Oc tober and March 1993-94 and 1991 95 were included in the study. Physic ians completed data forms on each patient. Information was validated b y review of the emergency-room records; further information was obtain ed by telephone. Results: A total of 226 patients were identified with ice-hockey-related head, neck, or facial injuries. Most injuries invo lved ed males (99%), and the mean age of patients was 23.9 (range, 4-6 3). Injuries occurred most frequently to the face [192 (85%)]. Many of the injuries were minor, with a mean injury severity score of 1.5 (ra nge, 1-25). However, three patients (1%) required hospital admission, and one teenager suffered a serious spinal fracture. Protective facial hockey equipment use was low in our sample, except among younger inju red players. Most of the facial injuries occurred in mature athletes p laying recreational hockey. Full facial protection reduced the chance of upper facial injury (p = 0.0001), but the risk of such injury while wearing a half-visor was the same as while wearing no facial protecti on at all (p > 0.05). From the current study, we estimate that these h ockey injuries result in similar to 2.7-3.0 million dollars of direct acute-care medical expenditure per year in emergency departments throu ghout Ontario. Conclusions: Head, neck, and facial injuries suffered d uring ice hockey participation are common problems presented to emerge ncy departments. Moreover, serious injuries can occur while playing th is sport. Most injuries appear to be preventable, and facial protectio n appears to be less frequently used, especially by older men, than is currently recommended. Prevention strategies are discussed.