Strengths & Limitations
This study is the first of its kind to evaluate maxillofacial trauma in the setting volleyball injuries. As such, providers can utilize patient specific patterns to better build comprehensive profiles and management plans for patients presenting with various types of injuries following volleyball participation.
The authors acknowledge several limitations; NEISS does not provide information that may enhance the conclusions of this study. Aspects of the injury setting (competitive game, practice, or recreational) or use of safety equipment are unknown. Certain outcomes, such as lacerations, contusions, or mild concussions, may be unreported as the injury may not have warranted an emergency department visit for treatment. Fractures, on the other hand, are likely to be seen by a healthcare worker, but may present at a primary care provider instead of the emergency department. Additionally, the database reports facial injuries as involving the head, face (including the eyelid, eye area and nose), eyeball/globe, mouth (including the lips, tongue, and teeth), neck and ear. There is significant cross-over with these structures which potentially impacted the analyses of the study. The specific nature and context of the injuries may increase or decrease presentation at the emergency department.32 Thus, our results likely underreport volleyball-related facial trauma.