Post-covid changes in the epidemiology of pediatric shoulder dislocations: A 10-year national database analysis

J Orthop. 2025 Aug 8;69:257-264. doi: 10.1016/j.jor.2025.08.010. eCollection 2025 Nov.

ABSTRACT

BACKGROUND: Previous studies have suggested that inactivity during the COVID-19 pandemic led to higher incidences of injury post-pandemic. This study aims to explore 10-year trends in pediatric shoulder dislocations presenting to United States emergency departments (EDs).

METHODS: The National Electronic Injury Surveillance System (NEISS) was queried for pediatric shoulder dislocations presenting to US EDs between January 1, 2014 and December 31, 2023. NEISS statistical weights were used to compute annual national estimates. A series of regression analyses were performed to measure annual trends stratified by gender, race, age, and activity. Finally, average incidence rates for the three most implicated activities for boys and girls were compared before, during, and after the COVID pandemic.

RESULTS: There were a total of 3724 pediatric shoulder dislocations reported in NEISS, representing a national estimate of 123,546 cases. Males sustained disproportionately more shoulder dislocations than females. Regression analyses revealed no significant trends for cohorts stratified by gender, race, or age, except for "Other/Mixed Race" whose annual rate decreased significantly (p < 0.01, β = -216.12). Shoulder dislocation rates for football (p < 0.05, β = -101.04) and basketball (p < 0.05, β = -109.82) also decreased significantly during the entire study period, and both activities maintained a decreasing trend for males post-Covid. For females, basketball and volleyball injury rates increased post-Covid, while atraumatic instability events in bed peaked during Covid.

CONCLUSIONS: Sustained lower rates of shoulder dislocations were observed for males in both basketball and football. Meanwhile, female shoulder dislocations decreased during but increased after the pandemic in both basketball and volleyball. Our study suggests females may be at higher risk of inactivity-related injury.

LEVEL OF EVIDENCE: Level IV; Cross sectional; Descriptive Epidemiology Study.

PMID:40823632 | PMC:PMC12357252 | DOI:10.1016/j.jor.2025.08.010