The National Epidemiology of Ankle Sprains in the United States: Updates From 2010 to 2024.

Abstract

Background: Ankle sprains are among the most common musculoskeletal injuries presenting to United States (US) emergency departments (EDs) and contribute substantially to health care use. This study provides updated national incidence rate estimates and characterizes trends in demographic and injury-related risk factors.

Materials and methods: The National Electronic Injury Surveillance System was queried for all ankle sprain cases treated in US EDs from 2010 to 2024. Incidence rates were calculated per 1,000 person-years using US Census data, and relevant stratified analyses were conducted.

Results: From 2010 to 2024, an estimated 7.4 million ankle sprains presented to US EDs, yielding an incidence of 1.53 per 1,000 person-years. Annual incidence declined from 2.12 in 2010 to 1.19 in 2024, with the lowest rate observed in 2020 (0.89) during the peak of the COVID-19 pandemic. Peak incidence occurred in adolescents aged 15 to 19 years (2.60 per 1,000), with over half of all sprains occurring in individuals aged 10 to 24. Female patients had a higher overall incidence than male patients (1.62 vs 1.44 per 1,000), peaking at ages 10 to 14 compared to 15 to 19, respectively. Athletic activity accounted for 33.2% of all sprains, with basketball alone responsible for 15.8% of cases. Most patients (99.5%) were treated and released without admission.

Conclusion: Ankle sprain incidence in US EDs has declined over the past 15 years but remains highest among adolescents, female patients, and athletes. A significant decline was observed during the COVID-19 pandemic. These findings provide updated national benchmarks and underscore the importance of preventive strategies in high-risk populations.