The Puck Stops Here: Head and Neck Ice Hockey Lacerations in Adults

Objective: The goal of this study was to describe lacerations of the head and neck sustained among ice hockey players in the US.

Methods: Data on adult (20-65 years) ice hockey injuries were collected from the 2003-2022 National Electronic Injury Surveillance System (NEISS) database. Injuries of the head, neck, face, mouth, and ears were included, while those sustained as a spectator, coach, or on a non-ice surface were excluded. Frequencies and means were calculated. A one-way ANOVA and chi-squared tests were performed, with p < 0.05 indicating statistical significance.

Results: Five hundred ninety-three patients were included; 578 (97.5%) male, 15 (2.5%) female. Mean age was 31.3 (95% CI 30.5-32.2) years. Lacerations occurred on the face (N = 422, 71.2%), mouth (N = 124, 20.9%), head (N = 23, 3.9%), ear (N = 22, 3.7%), and neck (N = 2, 0.3%). One patient (0.17%) was admitted due to closed head injury; there were no deaths. Pucks were the primary cause of lacerations (N = 210, 35.4%), followed by sticks (N = 135, 22.8%), collisions (N = 56, 9.4%), and falls (N = 51, 8.6%). 3.4% (N = 20) of patients experienced a laceration caused by a skate blade, most often on the face (N = 17/20, 85.0%).

Conclusion: Hockey pucks are the primary cause of lacerations in the head, face, and mouth, with neck lacerations being rare in this cohort. Full face protective gear would reduce the number of adult ice hockey head and neck lacerations.

Level of evidence: IV Laryngoscope, 2024.