This study, titled Hand and Wrist Injuries in Professional Hockey Players in Sweden: A Nationwide Observational Cohort Study from the Swedish Hockey League (SHL-HITT), aims to deliver a comprehensive national overview of hand and wrist injuries among professional hockey players.

These injuries are relatively common-accounting for approximately 16% of all hockey-related injuries-and can range from minor issues to severe conditions that jeopardize player performance and careers due to prolonged absences or lasting impairment. Despite their significance, there is limited detailed knowledge regarding the specific patterns, mechanisms, and consequences of hand and wrist injuries at the elite level.

Utilizing data from a nationwide injury registry, this observational cohort study will cover three full SHL seasons: 2022/23, 2023/24, and 2024/25. The dataset is expected to include approximately 2,300 games, encompassing both regular season and playoff matches. The study will examine injury characteristics such as type (e.g., fractures, soft tissue damage), player position, in-game timing, and additional contextual factors. Statistical analyses will be conducted to identify trends, correlations, and potential risk profiles among different player groups or positions.

The findings are expected to support the development of enhanced protective equipment and targeted prevention strategies, ultimately contributing to reduced injury incidence and improved athlete health and career sustainability.

The study timeline includes preparation in late 2024, with data collection already ongoing and ethical approval obtained. The analysis will begin following the publication of the study protocol, and we aim for final publication of results in the second half of 2025.

This nationwide observational cohort study, titled Hand and Wrist Injuries in Professional Hockey Players in Sweden: A Nationwide Observational Cohort Study from the Swedish Hockey League (SHL-HITT), aims to systematically characterize the epidemiology and distribution of hand and wrist injuries among elite ice hockey players in the Swedish Hockey League (SHL). Given that upper extremity injuries constitute a significant proportion of hockey-related trauma, with approximately 16% involving the forearm, wrist, and hand, this study addresses a critical gap in the literature regarding the incidence, nature, and severity of these injuries in professional athletes. Utilizing registry data collected since the 2022/23 SHL season, including detailed player baseline characteristics, injury diagnoses classified by ICD codes, and contextual game data, the study will employ descriptive and inferential statistical analyses to elucidate patterns of fracture and soft tissue injuries. Particular emphasis will be placed on evaluating injury mechanisms relative to player position and game situations. Statistical methods will include Pearson correlation, chi-square tests, and parametric or non-parametric tests as appropriate, with significance set at p<0.05. Findings from this study are expected to contribute valuable insights for the development of evidence-based injury prevention strategies and tailored protective interventions aimed at reducing the burden of hand and wrist injuries, thereby potentially enhancing player safety and performance outcomes in professional ice hockey.

Inclusion Criteria:

• Professional ice hockey players actively rostered in the Swedish Hockey League (SHL) during the 2022/23 season and onwards.
• Players with recorded forearm, hand or wrist injuries documented in the SHL injury register.

Exclusion Criteria:

• Players not officially signed to an SHL team during the study period.
• Injuries occurring outside the forearm, hand or wrist region.
• Incomplete or missing injury data in the registry.

The study population includes professional ice hockey players registered in the Swedish Hockey League (SHL) from the 2022/23 season onward. This cohort encompasses athletes of varying positions who have sustained hand or wrist injuries documented in the league's injury registry.

Any data shared with colleagues or collaborating researchers will be fully anonymized or pseudonymized to protect participant privacy in accordance with GDPR regulations. Data transfers will occur under strict confidentiality agreements, and all parties will adhere to applicable data protection laws to ensure the security and privacy of personal information. We will act in accordance with the ethical approval granted by the Swedish Ethical Review Authority (EPM) and comply with all relevant local policies regarding data protection.

From the publication of the protocol and for 10 years thereafter.

Access to individual participant data is typically restricted to authorized researchers involved in the study or approved collaborators under strict confidentiality and data protection agreements.