Ski Injuries Research Articles

Kinematics of a slip-catch mechanism for anterior cruciate ligament injury in world cup alpine skiing

BackgroundWe have identified that a slip-catch situation is the main mechanism for anterior cruciate ligament (ACL) injuries in World Cup alpine skiing by simple visual inspection of injury videos. This...

Mechanisms of anterior cruciate ligament injury in world cup alpine skiing: a systematic video analysis of 20 cases

BackgroundWe have limited insight into the mechanisms of anterior cruciate ligament (ACL) injuries in alpine skiing, particularly among professional ski racers.ObjectiveTo describe the mechanisms of ACL injury in World Cup...

Schneesportverletzungen im Schulsport. Möglichkeiten der Prävention

During a period of ten years (2000 - 2009) 1522 school sports injuries have been reported to the health insurance agency (Allgemeine Unfallversicherungsanstalt) from all secondary schools in Tyrol. The major disciplines were ski (48%, n = 734), ice skating (23%, n = 349) and snowboard injuries (21%, n = 315), followed by tobogganing (6%, n = 91), cross-country skiing (1%, n = 17) and other snow sports (1%, n = 16). Preventive measures such as a fitness and coordinative training prior to winter sport courses, appropriate breaks and proper protective gear (i.e. helmet and spine protector) may reduce the injury rate in snow sport.

Comparison of Ski and Snowboard Injuries that Occur Inside Versus Outside Terrain Parks

Skiing and snowboarding are sports with an inherent risk of injury. Recently there has been an increasing interest in performing tricks, with the implementation of terrain parks at resorts worldwide. The addition of terrain parks at resorts has likely changed injury patterns and frequencies.PURPOSE:

Injury Prevention Strategies in Skiers and Snowboarders

With associated snow sports injury risks being well documented, the scope for preventative medicine is clear. This article focuses on potential precautions taken by skiers/snowboarders and how they vary between different snow sport groups. A total of 181 randomly selected individuals from the Whistler/Blackcomb Medical Centre, Canada, took part in this questionnaire-based cohort study, examining snow sports activity, preventive measures, and protective equipment use. Most individuals were ski area residents of advanced expertise, with 50% having had a previous snow-riding injury. The most commonly reported significant ski injury was anterior cruciate ligament (ACL) rupture, while in snowboarders, it was wrist fracture. Skiers were more likely to improve fitness levels before going onto the slopes, whereas crossover riders (both skiing and snowboarding) were more likely to take lessons. Most individuals used eye and sun protection and had adequately warm clothing. Beyond basic precautions, protective equipment and preventive measures are used infrequently. It is suggested that by increasing awareness and use of such equipment, injury rates may be reduced.

Skiing and Boarding Injuries on Norwegian Slopes during Two Winter Seasons

Abstract A central ski patrol-based registration of skiing and boarding injuries was performed by the Norwegian Ski Lift Association during the winter seasons of 2006/2007 and 2007/2008. A total of 8149 injured skiers/boarders and 6.024 million skier/boarder days were recorded during the two seasons, giving an injury rate of 1.35 injured per 1000 skier/boarder days. Most of the injuries occurred during alpine skiing (64 %) and snowboarding (31 %), compared to telemark skiing (2 %) and skiboarding (3 %). Wrist injuries were common among injured snowboarders (25 %) compared to 4–6 % for the others (P<0.001). The knee was the main injury location in alpine skiers (25 %) compared to 21 % among skiboarders, 19 % among telemarkers, and only 8 % among snowboarders (P<0.001). The percentage of knee injuries in females (30 %) was almost twice as high as for males (16 %) (P<0.001), whereas shoulder injuries was twice as high in males (16 %) as in females (7 %) (P<0.001). As percent of all injuries injured snowboarders suffered more fractures (30 %) than skiboarders (27 %), alpine (22 %), and telemark skiers (18 %) (P<0.001), but fracture of the lower leg was uncommon among snowboarders (0.5 %) and telemarkers (0.6 %) compared to alpine skiers (6 %) and skiboarders (9 %) (P<0.001). Lower leg fractures accounted for 5 % of the injured alpine skiers 20 years and older, 3 % for adolescents aged 13–19 years compared to 12 % for children 12 years and younger (P<0.001). Nineteen percent of the skiers/boarders were injured in terrain parks. They suffered more fractures and back injuries than those injured at other locations (P<0.001). Fifty-seven percent of injured skiers/boarders used helmet, and they had a lower prevalence of head injuries (15.9 %) than those without helmet (18.2 %) (P<0.01). In conclusion, injured alpine skiers were most prone to knee injuries, and skiboarders to lower leg fractures. This fracture was still a common injury for children in these two disciplines. Injured snowboarders were most prone to suffer wrist injuries. The prevalence of knee injuries among females was almost twice that of males, whereas the reverse was observed for shoulder injuries. Injured skiers/boarders wearing a helmet had a lower prevalence of head injuries than those without helmet.

Are ACL Injuries Related to Perceived Fatigue in Female Skiers?

Abstract In alpine skiing, knee injuries show marked sex differences, as female recreational skiers have a twofold greater incidence of knee injuries and a threefold higher anterior cruciate ligament (ACL) injury risk than male skiers. General preventive recommendations to reduce the incidence of ski injuries include avoiding fatigue. However, no study has yet examined to which extent ACL injuries in female recreational skiers are related to perceived fatigue. Therefore, 68 ACL injured female skiers and 136 matched controls were interviewed about skiing time and perception of fatigue in legs and the whole body at the time point of accident and questioning, respectively. In addition, skiing ability, self estimated fitness level, quantity and quality of breaks per run, sleeping quality, and group skiing and skill level of group members have been recorded. Patients and controls differ significantly regarding the duration of skiing as about 81 % of ACL injuries occurred within the first 3 h (odds ratio=4.4; P<0.001). In patients about 71 % and in controls about 27 % felt no fatigue or a trace of fatigue in their legs at the time of injury and questioning, respectively (P<0.001) . No other factors showed a significant difference. Therefore, fatigue seems no major risk factor for an ACL injury in female recreational skiing.

Einfluss des Skischuhs auf das Gleichgewichtsverhalten

Modern ski carving technique demands that skiers have a strong sense of balance and edge their skis with precision and feeling. Stiff ski boots facilitate the transfer of power to the ski but increase the difficulty of balancing. The aim of this study was to analyse the influence of ski boots on balance performance of alpine skiers. 76 experienced skiers (female 33/male 43) and 76 ski racers of the Skigymnasium Stams (female 31/male 45) were tested on the MFT S 3 Check with and without ski boots. Ski boots significantly influenced balance. There were also significant differences between experienced skiers and ski racers, but gender differences were minimal. In addition to general conditioning, skiers should utilise general and ski-specific balance and sensomotor training which could help in ski injury prevention, especially knee injuries.

Poster 125: Descriptive Epidemiology of Ski and Snowboard Injuries by Age Group: Children/Adolescent, Young Adult, Adult

Poster 125: Descriptive Epidemiology of Ski and Snowboard Injuries by Age Group: Children/Adolescent, Young Adult, Adult

Bread Mold Osteomyelitis in the Femur

Rhizopus osteomyelitis is an uncommon and often fatal infection that usually occurs in immunocompromised patients. The infection is commonly referred to as "bread mold." The usual course of treatment is Amphotericin B, debridement, and, if needed, amputation of the affected limb. This article details a rare case of postoperative Rhizopus osteomyelitis in an otherwise healthy patient. The patient originally presented at another institution for anterior cruciate ligament repair after a ski injury. Postoperatively, he developed clinical evidence of infection. He was referred to our institution with stiffness and swelling in the knee as well as weight loss and decreased range of motion. Fluid collection was visible on magnetic resonance imaging. Arthroscentesis was cultured for fungus and bacteria, and the fungal cultures were positive for Rhizopus species. An attempt at limb salvage was made. Debridement, use of a cement spacer loaded with Amphotericin B, systemic antifungal therapy, and 23 hyperbaric oxygen treatments were used to eradicate the disease. Four surgeries were needed to eradicate the disease, and 10 months after initial presentation, the patient had a distal femoral endoprosthesis placed in his leg. Laboratory tests returned to normal and frozen sections were negative for fungus. At 3-year follow-up, the patient reported a musculoskeletal functional score of 50% and had no evidence of recurrent infection.

Right Shoulder Injury-skiing

HISTORY: A 16 year old male alpine ski racer sustained and injury to his right shoulder while crashing in a giant slalom training. He reported that it felt as if his shoulder was dislocated, it was terrible painful and he was unable to move it through any considerable range of motion. The ski patroller at the race course placed his arm and the athlete was brought to the medical doctor who placed his arm in external rotation and apparently reduced the shoulder. The arm was fixed at the trunc with a bandage. PHYSICAL EXAMINATION: The athlete was evaluated one week later for the complaint of apprehension and inability to return to ski competition 10 days after the injury. The right shoulder examination was significant for abnormal scapulothoracic rhythm with scapular hiking present but nearly full active abduction. Active internal rotation was limited to approximately 25 degrees and active external rotation to approximately 30 degrees. Passively slightly more motion was possible but produced significant pain. Strength was reduced within the available motion but again produced discomfort. Although apprehension signs were negative, Neer's, Hawkin's, O'Brian's and anterior glide tests were all positive. DIFFERENTIAL DIAGNOSIS: Labral tear (Bankart lesion), Hill Sachs lesio, Rotator Cuff impingement vs. strain or tear, AC joint lesion TEST AND RESULTS: Shoulder x-ray ap and lateral shows no pathological signs. Shoulder MRI: Hill Sachs lesion Tear in the anterior-inferior labral area (Bankart lesion) Rotator cuff muscles intact AC-joint intact FINAL WORKING DIAGNOSIS: Bankart and Hill-Sachs lesion TREATMENT AND OUTCOMES: Ice, Bandage for 10 days, manual lymph-massage, high-voltage electrotherapy, low-level-laser therapy Activity - training - modification Initial therapeutic exercise consisted of active and active assisted shoulder range of motion exercises in all planes Underwater therapy in closed chain exercises Scapular stabilisation exercises Gradually advances to a progressive shoulder girdle and rotator cuff strengthening programme as full pain-free motion returned Sport specific conditioning initiated 2 month post injury - starting with skiing with special bandage 3 months after injury return to competition was possible - no problems

Mechanisms And External Causes Of Injuries Among Patients At A Ski And Snowboard Resort Clinic

(No relationships reported) BACKGROUND: We are developing a multi-center, long-term injury surveillance system for ski and snowboard injuries and have collected two years of pilot-scale data at a single resort. We retrospectively reviewed all injuries seen at a single medical clinic located at the base of a mountain resort. An analysis of two aspects of these injuries _ spine injuries and listening to music as an external cause _ is presented here. Our longer term goal is to use surveillance data to identify mechanisms of injury and devise and test injury prevention interventions. PURPOSE: To quantify and describe the injuries seen at one clinic during the 2007-2008 winter season, accounting for patron load with emphasis on spinal injuries and listening to music. METHODS: Medical records and ski patrol report forms were analyzed for N=1,639 patients seen at a mountainside clinic between November 2007 and April 2008. RESULTS: Median age of all patients was 22 years with males younger than females (p<0.05) and helmet use more common among younger patients (p<0.001). Injured snowboarders (mean=21 years) were younger than injured skiers (34 years) (p<0.001) and had increased odds (OR=1.5) of spinal injury, but were more likely to be wearing a helmet (OR=1.4) (p<0.05). Several mechanisms were associated with increased odds of spinal injury compared to the most common mechanism of 'catching an edge' including: out of control (OR=2.4), landing short (OR=2.8) or long (OR=6.9) off of a jump, and hit by a snowboarder (OR=6.3). Patients injured in a terrain park were younger (20 vs. 29 years), more likely to be male (OR=5.3), and listening to music (OR=4.8) than those injured elsewhere. (p<0.001. Snowboarders comprised 70% of patients injured in a terrain park. Patients listening to music when injured were younger (23 vs. 28 years) and more likely to be snowboarding (OR=2.9) than those patients not listening to music (p<0.001). CONCLUSIONS: Reported results are limited to patients seen in clinic. Without denominator data, rates cannot be calculated. Demographics and behaviors can predict risk of some injuries. Modifiable factors such as skill level and concomitant distractions affect risk of injury. Surveillance is ongoing. We will begin data collection using an electronic medical record for the 2008/9 season. ACKNOWLEDGMENTS: Utah Sports Research Network.

Risikoverhalten und Sicherheitsempfinden bei Ski- und Snowboardfahrern

Injuries in leisure sports, especially with skiers and snowboarders are a challenge for medicine as well as for economy. The risk of getting injured depends not only on the performed sport but also on the individual readiness to take a risk and the worn safety devices. 663 persons performing leisure sports in an alpine ski resort were questioned concerning their individual readiness to take a risk and need for security. It was distinguished between skiers and snowboarders. Also the worn safety devices as well as the reasons for and against the use of safety devices were asked. As safety devices helmets, back protectors, wrist guards, knee-, shin- and elbow pads were considered. There were also questions about the behaviour on the ski slope and injuries so far. 52.5 % of all questioned persons are skiers, 36.0 % snowboarders, 11.5 % practise both sports. Safety devices are widely accepted in leisure sports: 78.1 % of all persons questioned wear at least one device. 76.8 % wear it for their own safety. The most common reason against safety devices are "lack of need" with 59.6 %. 28 % mentioned lack of comfort. Males show a significantly riskier behaviour on ski piste than females, 7 versus 5 on an analogue scale 0 - 10. After all 47.2 % of all persons have suffered from an injury, which needed medical treatment. In 75.7 % the cause was a fall, 14,7 % were results of a collision. In this context 49.5 % would appreciate the introduction of a ski slope controller. 90.5 % deny the consumption of alcohol while performing their sport and 78.4 % consider the consumption of alcohol as a risk either for themselves or for others. Our study shows a broad acceptance of safety devices in leisure sport. A lot of studies have proved the value of helmets to prevent injuries. The introduction of mandatory helmets at least for children and juveniles in alpine sports would be well accepted. Males show a significantly riskier behaviour on ski pistes than females. Efficient controls on ski pistes to avoid ruthless behaviour would be appreciated and declined by equal numbers.

Severe spinal injuries in alpine skiing and snowboarding: A 6-year review of a tertiary trauma centre for the Bernese Alps ski resorts, Switzerland

Severe spinal injuries in alpine skiing and snowboarding: A 6-year review of a tertiary trauma centre for the Bernese Alps ski resorts, Switzerland

Ski Bindings and Lower Leg Injuries, A Case Control Study in Flaine, 2006

Abstract There has been much discussion in recent years regarding appropriate settings for release bindings in Alpine skiing. The authors take into account the fact that current recommended release criteria are based on midshaft tibia bone strength. The hypothesis of this work is to look at a link between binding release values and all lower limb injuries. Additionally, there is a proposal regarding the possibility of reducing injuries to the ligaments in the knee through modification of binding release value standards. Knee injuries including rupture of the anterior cruciate ligament remain a major risk for skiers and for women in particular. In July, 2000, the French standards group, AFNOR, recommended a modification to the ISO 11088 standard for release settings specifically designed to reduce binding release values particularly for women and for individuals with body weight less than 55 kg. The objective of this study is to measure the influence of binding release values on lower leg injuries, in particular for women. A case-control study at Flaine ski resort in 2006 was conducted to determine whether there is proof of causation between ski binding release values and lower leg injuries sustained on the ski slopes. Release torque values were measured for injured (n=129) and control (n=339) groups. The measurements were made for Alpine skiers by using standard measurement devices. Comparisons between recommended release settings based on AFNOR FD S 52-748 compared to actual release levels as a function of fall mechanism speed, type of release, type of ski, and self-reported experience level were analyzed statistically. There is a statistical link between AFNOR standard ski binding release values and injuries of lower limbs. We believe it is important to introduce a gender parameter in ISO binding release value tables to reduce the release values for women.

NEW SKIING TECHNIQUES – NEW INJURIES? ANALYSIS OF SKI INJURIESIN 2004/2005

BACKGROUND New developments in ski technology have influenced the rate and structure of ski injuriesin the past. Lately, skies and snowboards with carved steel edges have taken over traditionally shaped skies and introduced a new, so called »carving« technique. In this paper weanalysed ski injuries treated at Department of Traumatology during 2004 and 2005, tosee whether new equipment and skiing techniques have changed injury rate and pattern. RESULTS The rate of ski injuries has not changed importantly while the pattern is quite different. Thenumber of high velocity and high energy injuries has raised, leading to higher number ofhead, trunk and multiple injuries. Number of upper extremity injuries has raised predominantly due to snowboarding. Carved edges and carving led to some new tipical mechanisms of injuries to the knee and upper tibia. CONCLUSIONS New design of skies and snowboards with carved edges have changed skiing technique.The velocity of skiers has raised, ski-tracking is defined by radius of ski edges and decreasedabillity to decelerate or to change direction in carving have led to new injury patterns. Newmechanisms of injuries dictate changes of security measures such as new release systemsof ski bindings, protection braces, skiing technique improvements and improved resortmanagement and safety

Do Sleep Disorders Have an Impact on Blood Pressure?

In this article, the relationship, perhaps interdependence, between sleep-disordered breathing, hypertension, and obesity is discussed. There is strong evidence that sleep-disordered breathing and hypertension are related. On the one hand, the prevalence of hypertension increases with the number of apnea-hypopnea episodes per hour of sleep, whereas on the other hand, treating sleep-disordered breathing reduces hypertension. It has also been shown that this relationship between sleep-disordered breathing and hypertension is stronger in individuals with a high body mass index. Thus, it is concluded that in individuals presenting with hypertension, sleep-disordered breathing, or increased weight, the two other variables must be investigated and treated if present.

Case report: Brown-Séquard syndrome resulting from a ski injury in a 7-year-old male

Cervical spine and spinal cord injuries are rare in pediatric trauma victims. The majority result from blunt trauma. Spinal cord injury without radiographic abnormality has been reported to be more common among young children than adults. The Brown-Séquard syndrome is rarely seen as the result of blunt trauma. We present the case of young boy who suffered spinal cord injury without radiographic abnormality resulting in the Brown-Séquard syndrome and review the controversy surrounding the use of high-dose corticosteroids in the treatment of pediatric spinal cord injury. Current data do not support the use of corticosteroids as 'standard of care' for this population.

Injury Trends in Norwegian Ski Resorts in the 10 Year Period 1996–2006

Abstract A central ski patrol-based registration of skiing and boarding injuries was performed by the Norwegian Ski Lift Association during the winter seasons 1996/1997–2005/2006. Totals of 31 175 injured skiers/boarders and 21.898 million skier/boarder days were recorded during the ten seasons, giving an injury rate of 1.4 injured per 1000 skier/boarder days. Most of the injuries occurred during alpine skiing (49–58 %). Snowboarding injuries peaked with 45 % in the middle of the period decreasing to 35 % the last two seasons. Telemark skiing and skiboarding each accounted for less than 10 % of the injuries. Wrist injuries were most common among injured snowboarders and knee injuries among injured alpine skiers. The percentage of knee injuries was almost twice as high for females compared to males throughout the period (p&amp;lt;0.001). The prevalence of lower leg fracture for injured alpine skiers ⩽12 years decreased from 20 % to 13 % in the period (p&amp;lt;0.001), whereas the corresponding prevalence for teenagers and adults was relatively stable at 3–5 %. Injuries in terrain parks increased to 20 % of all injuries at the end of the period. The use of helmets among injured skiers/boarders increased from 11 % to 44 % in the 10-year period (p&amp;lt;0.001), whereas the prevalence of head injuries decreased from 19 % to 17 % (p&amp;lt;0.003). In conclusion, the injury rate has been almost constant during the last six seasons in Norwegian ski resorts. The prevalence of lower leg fracture has decreased in injured alpine skiers ⩽12 years. The use of protective helmet has increased by injured skiers/boarders and the prevalence of head injuries has decreased.

Injuries in Norwegian Ski Resorts the Winter Seasons of 2005 and 2006

Abstract A central ski patrol-based registration of skiing and boarding injuries was performed by the Norwegian Ski Lift Association during the winter seasons 2004/2005 and 2005/2006. Totals of 8130 injured skiers/boarders and 5.466 million skier/boarder days were recorded during the two seasons, giving an injury rate of 1.5 injured per 1000 skier/boarder days. Most of the injuries occurred during alpine skiing (58 %) and snowboarding (35 %), compared to telemark skiing (3 %) and skiboarding (4 %). Wrist injuries were common among injured snowboarders (26 %) compared to only 5 % each for the others (P&amp;lt;0.001). The knee was the main injury location in alpine skiers (24 %) compared to 23 % among skiboarders, 14 % among telemarkers and only 7 % among snowboarders (P&amp;lt;0.001). The percentage of knee injuries in females (28 %) was almost twice as high as for males (P&amp;lt;0.001), whereas shoulder injuries were twice as high in males (17 %) as in females (8 %) (P&amp;lt;0.001). As a percentage of all injuries, skiboarders suffered more fractures (34 %) than snowboarders (33 %), telemarkers (26 %), and alpine skiers (22 %) (P&amp;lt;0.001), but fracture of the lower leg was uncommon among snowboarders (1 %) and telemarkers (3 %) compared to alpine skiers (6 %) and skiboarders (13 %) (P&amp;lt;0.001). Lower leg fractures accounted for 4 % of the injured alpine skiers 20 years and older, 3 % for adolescents aged 13 – 19 years compared to 13 % for children 12 years and younger (P&amp;lt;0.001). Twenty percent of the skiers/boarders were injured in terrain parks. They suffered more fractures, head, and back injuries than those injured on groomed slopes (P&amp;lt;0.01). In conclusion, injured alpine skiers were most prone to knee injuries, and skiboarders to lower leg fractures. This fracture was still a common injury for children in these two disciplines. Injured snowboarders were most prone to suffer wrist injuries. The prevalence of knee injuries among females was almost twice that of males, whereas the reverse was observed for shoulder injuries.