Hand injuries in Alpine skiing

Abstract

In the Innsbruck University Clinic for Traumatology during the years 1978-1985, altogether 17,999 patients received initial treatment for injuries incurred through Alpine skiing. 3240, or 18% of these injuries were trauma to the hand. The most frequently injured area was the thumb, with 1995, or 61.6% of the cases. The most common hand injury in skiing is the socalled "ski thumb", the lesion of the ulnar ligament of the metacarpal-phalangeal joint. Finger injuries accounted for 262 cases, or 8%. The capsule-ligament lesions predominated, especially the palmar capsule lesion of the proximal interphalangeal joint. The most common ligament lesion was the rupture of the radial collateral ligament of the metacarpal-phalangeal joint of the small finger. The metacarpal region was involved in 192 (6%) of the patients. The 4th and 5th metacarpal fractures were often combined with volar dislocation of the caput; the 2nd and 3rd metacarpals showed more often torsion fractures. Luxated fractures were found in all carpal-metacarpal joints. Carpal injuries were the least common, with 2.2%; the bony and ligamentous injuries in this region were, however, more serious. 40 scaphoid fractures were found, along with fractures of the triquetrum, trapezium, hamatum, and pisiform, as well as luxations and luxated carpus fractures. The injuries of the wrist are worthy of more attention. They include lesions of the distal radial-ulnar joint and distal radius fractures, and made up 22.2% of all hand injuries. More emphasis should be placed on diagnostic, therapeutic, and prophylactic measures for these injuries.