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Alpine ski and snowboarding traumatic injuries: incidence, injury patterns, and risk factors for 10 years.

Am J Surg. 2009 May;197(5):560-3; discussion 563-4

Authors: McBeth PB, Ball CG, Mulloy RH, Kirkpatrick AW

BACKGROUND: Alpine skiing and snowboarding are popular winter sports in Canada. Every year participation in these activities results in traumatic injury. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with ski and snowboarding injuries. METHODS: A comprehensive 10-year retrospective review of Alpine ski and snowboarding injuries from 1996 to 2006 was conducted. The Alberta Trauma Registry was used as the primary source of data. RESULTS: A total of 196 patients (56.6% skiers, 43.4% snowboarders) were identified as having major traumatic injuries (Injury Severity Score, >or=12). Forty-three patients required intensive care unit support. The majority of injuries were related to falls and collisions with natural objects. Head injuries were most common, followed by chest, spinal, and extremity trauma. Seventy-nine patients required emergency surgery. CONCLUSIONS: Skiing and snowboarding represent activities with high potential for traumatic injury. Safety initiatives should be developed to target this population.

19306973

– Alpine ski and snowboarding traumatic injuries: incidence, injury patterns, and risk factors for 10 years.

Effect of simulated lateral process talus “fracture excision” on its ligamentous attachments.

Am J Orthop (Belle Mead NJ). 2009 May;38(5):222-6

Authors: Langer P, Nickisch F, Spenciner D, DiGiovanni C

Recent epidemiologic studies highlight lateral talar process fractures as snowboarder’s fracture or snowboarder’s ankle. Snowboarding is the fastest growing sport worldwide, so lateral talar process fractures are increasing in frequency and mandating a more careful assessment of injury patterns, surrounding tissue involvement, and treatment strategy. In this study, we evaluated the effects of lateral talar process fracture on the footprints of 3 lateral stabilizing ligaments of the ankle and subtalar joint-the lateral talocalcaneal ligament (LTCL), the anterior talofibular ligament (ATFL), and the posterior talofibular ligament (PTFL). The musculotendinous structures from 10 fresh cadaveric limbs were removed and the distal fibula reflected to provide visualization of the lateral talar process and ligamentous attachments. Length and width of the LTCL, ATFL, and PTFL footprints on the lateral process of the talus were measured with calipers before and after removal of a 1-cm(3) simulated fracture fragment. Relative changes in the attachment site areas for the 3 ligaments were determined. Mean pre-excision footprint areas were 80.57 mm(2) (LTCL), 224.38 mm(2) (ATFL), and 394.18 mm(2) (PTFL); mean postexcision footprint areas were 2.10 mm(2) (LTCL), 194.89 mm(2) (ATFL), and 335.18 mm(2) (PTFL); and mean decreases calculated as percentages of the original areas were 97.5% +/- 3.5% (LTCL), 11.7% +/- 13.0% (ATFL), and 14.3% +/- 12.3% (PTFL). Removal of a 1-cm(3) bony fragment from the lateral talar process involves 3 of the major lateral stabilizing ligaments: approximately 100% of LTCL and approximately 10% to 15% of ATFL and PTFL.

19584991

– Effect of simulated lateral process talus "fracture excision" on its ligamentous attachments.

[Review of patients with musculoskeletal injury treated during winter months in a highland hospital]

Cas Lek Cesk. 2009;148(7):303-8

Authors: Rousek M, Rousek M, Dzupa V

BACKGROUND: The authors examined the incidence of musculoskeletal injuries according to their type and location in the period of winter at a highland hospital, which also functions as a regional hospital for a few winter sport resorts. METHODS AND RESULTS:. In the sample there were 1644 patients (696 women, 948 men) treated for primary musculoskeletal injuries from 1.1. to 31.3.2008. This was a retrospective study; the data were collected from medical reports. It included: age, sex, mechanism of injury, diagnosis and whether the patient had to be hospitalised or not. Age of the patients ranged from 1 to 95 years with an average of 29 years (31 for women and 28 for men). Younger age groups dominated among men. After 70 years of age there was a prevalence of women. Fractures were the most common cause of injury (653, 39.7%), followed by injuries to the joints’ ligamentary apparatus by mechanism of distortion (379, 23.1%). Next in incidence were soft tissue injuries caused by contusion (325, 19.7%) and open wounds (241, 14.7%). The least common were luxated joints (43, 2.6%) and closed injury to muscles and tendons (3, 0.1%). The most frequent site of injury was the hand (404, 24.6%), while the least frequent place was the thigh (17, 1.0%). CONCLUSIONS: In conclusion the study confirmed that other than the age, gender and the season, the geographic location also influences the spectrum of musculoskeletal injuries. The study also showed that the most common type of injuries was that of the upper extremity. The study did not confirm the expected prevalence of fractures among women. The prevalence of men was probably because of the prevalence of winter sport activities as a leading cause of injury (mostly skiing and snowboarding).

19642295

– [Review of patients with musculoskeletal injury treated during winter months in a highland hospital]

An analysis of skiing and snowboarding injuries on Utah slopes.

J Trauma. 2009 Nov;67(5):1022-6

Authors: Wasden CC, McIntosh SE, Keith DS, McCowan C

BACKGROUND: Injuries sustained while skiing or snowboarding are commonly encountered in emergency departments near winter resorts. The purpose of this study is to identify and compare the types of injuries likely to be found in the skier or snowboarder patient. An additional goal of this study is to provide a description of the demographics and hospitalizations for these patients. METHODS: A retrospective cohort study consisting of patients treated for skiing- or snowboarding-related injuries was performed at the University of Utah Medical center. All emergency department visits were captured: walk-ins and emergency medical service transports (ground and air). Seven hundred ninety-four skiing and 348 snowboarding-related cases were identified for a total of 1,142. Cases that occurred within 2001/2002 to 2005/2006 seasons were included in the study. Injuries were classified according to the International Classification of Diseases-9th Revision system and categorized by body location and specific type of injury. Outputs for this study include the chi test using the skiers as the control group due to size, with risk odds ratios comparing snowboarders to skiers. A p value of <0.05 was considered significant. RESULTS: Patients injured while skiing and snowboarding were predominantly men, representing 70.0% of injured skiers and 87.6% of injured snowboarders. The mean age for skiers was 41 (SD = 16), whereas the mean age for snowboarders was 23 (SD = 8). High percentages of patients among both groups had suffered injury to the head, which was more common in snowboarders when compared with skiers (27.3% vs. 20.4%, p = 0.010). Despite this fact, skiers tended to have slightly higher percentages of Glasgow Coma Scores in the moderate to severe range and accounted for all fatalities secondary to head injury (8 of 9 fatalities). The single snowboarder fatality was not caused by head injury but rather pneumothorax. Injuries to the head that were more common in skiers were fractures to the facial bones (5.2% vs. 1.4%, p = 0.003) and facial lacerations (5.8% vs. 2.9%, p = 0.035). Skiers were more likely to sustain injuries to the lower extremities (51.3% vs. 26.2%, p < 0.001), whereas snowboarders commonly had injuries to the abdomen and its organs (22.4% vs. 11.2%, p < 0.001). A considerable amount of snowboarders had injuries to the spleen (11.2%), liver (3.7%), and kidney (2.2%). Injuries to the spine were common in both groups but more in snowboarders (20.7% vs. 13.4%, p = 0.002). On an average, skiers spent 3.4 days in the hospital (SD = 3), a day longer than snowboarders who averaged 2.4 (SD = 2). Skiers were more frequently admitted to the floor or the operating room, whereas snowboarders were more often admitted to the intensive care unit. CONCLUSION: Patients injured while skiing or snowboarding are predominantly men, and participants in both sports are at risk for sustaining major injuries. The types of injuries differ and are dependent on the sport. An awareness of these differences will help skiers and snowboarders minimize their risk of injury by altering their riding strategies and by choosing appropriate protective equipment.

19901663

– An analysis of skiing and snowboarding injuries on Utah slopes.