Background: Several authors have analyzed the incidence of handball injuries in amateur players but information of handball injury in top-level players is very limited. The aim of the study was to analyze the incidence, circumstances and characteristics of handball injuries during major international tournaments. Methods: Injuries during six international handball tournaments were analyzed, using an established injury report system. The physicians of all participating teams were asked to report all injuries after each match on a standardized injury report form. The response rate was on average 87%. Results: The incidence of injury was on average 108 injuries/1000 player hours (95% confidence interval (CI): 98-117) or 1.5 injuries/match (95% CI: 1.4-1.6). The injuries affected most frequently the lower extremity (42%), followed by injuries of the head (23%), upper extremity (18%) and trunk (14%). The most frequent diagnosis was contusion of head (14%) or ankle sprain (8%). The majority of injuries were caused by contact with another player. The incidence of time loss injuries was on average 27/1000 player hours (95% CI: 22-32), and significantly higher in men than in women. Conclusion: Preventive program proven effective should be implemented. Fair Play is an essential aspect of injury prevention. Therefore, close cooperation with the referees is also necessary to make handball a safer sport.
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