Inj Epidemiol

BackgroundAnkle sprains account for a large proportion of injuries presenting to both United States (US) emergency departments (EDs) as well as high school (HS) and collegiate school athletic training settings. The epidemiologic differences across these settings by both sport and diagnosis have not been well differentiated.ResultsDuring the study period, the surveillance systems captured 20,261 ankle injuries presenting to EDs plus 5546 HS and 2725 collegiate injuries presenting to school athletic training settings. Rates were higher in collegiate compared to HS athletes presenting in the athletic training setting. Football accounted for the largest proportion of ankle injuries presenting to HS (31.2%) and college (41.0%) athletic training settings; male basketball accounted for the largest proportion presenting to EDs among both HS (41.0%) and college (65.8%) aged patients. Sprains/strains accounted for over 80% of injuries in all three settings. Fractures accounted for a larger proportion of ankle injuries presenting to EDs (9.5%) compared to HS (3.8%) and college (0.8%) athletic training settings. There was no change in injury rates during the study period across the three settings.ConclusionsInjury rates and patterns varied by sport and presentation setting, with athletic trainers evaluating more ankle injuries overall in the collegiate setting compared to the high school setting. Ankle injuries presenting to EDs were more commonly fractures, suggesting that more severe injuries present to this setting. Understanding the epidemiology of such patterns will help readers interpret differences in publications reporting data from varied clinical settings.Electronic supplementary materialThe online version of this article (10.1186/s40621-018-0163-x) contains supplementary material, which is available to authorized users.R49 CE000674/CE/NCIPC CDC HHS/United StatesR49 CE001172/CE/NCIPC CDC HHS/United StatesR49/CE000674-01 and R49/CE001172-01/Centers for Disease Control and Prevention/2018-09-03T00:00:00Z30175385PMC611967