Real Injuries on the Virtual Frontier: Seven-Year Injury Trends in Virtual Reality

Background and/or Objectives: With evolution in the development of, and participation in Virtual Reality (VR) related activities, there may be a unique injury pattern developing in the general population. The objective was to describe the emerging injury burden, injury mechanisms, and patient characteristics engaged in VR activities.

Design: Descriptive epidemiologic study using the National Electronic Injury Surveillance System (NEISS) database to quantify annual case volumes of VR-related injuries treated in U.S. emergency departments (ED) from the first documented case in 2017 to 2023.

Setting : EDs from 100 nationally-representative hospitals.

Participants : Patients presenting to the ED with a VR related injury (N=4,356).

Interventions: NA

Main Outcome Measures: Annual case number and National Estimates of VR-related injury; Diagnoses: Injury location and mechanism; Treatment disposition.

Results: There were 6,043 VR-related injuries during this time frame (72.1% male; 23.2±23.6yr). The number of ED cases increased more than 10-fold from 221 to 2,847 by 2022 (p < 0.005). A dramatic reduction in cases occurred in 2023 to 1,028 injuries. The average age range of patients between 2017-2021 was 24.7yr-39.3yr, subsequently decreasing to 15.2yr by 2023 (p=0.006). The most-commonly injured body part was the finger (n=1,698, 28.1%), followed by the head (n=656, 10.9%), and the hand (n=634, 10.5%). The most frequent diagnoses were laceration (n=1,291, 21.4%), followed by fracture (n=1,168, 19.3%), and concussion (n=712, 11.8%). The most common mechanism of injury was hit-punch-strike-slam-kick-run (51.7%), followed by falls (20.1%) and jump-twist-swing (10.8%). Almost all patients were discharged home (98.9%).

Conclusions: These emerging injury patterns may be related to a combination of industry trends towards ergonomically-sound equipment design and safety improvement, and higher fidelity motion tracking to accurately represent body movement in space. The reduction in average patient age over time is a concern, and future studies should continue to follow these trends in injury rates to optimize ergonomics and safety.