Paragliding accidents--the spine is at risk. A study from a Swiss Trauma Centre

Accidents and injuries related to paragliding on mount Babadağ, Turkey: A cross-sectional study

OBJECTIVES

In light of the growing popularity of paragliding, this cross-sectional study aimed to investigate the epidemiology of paragliding accidents, providing insights into the types and severity of injuries sustained as well as the body regions most commonly affected.

METHODS

This cross-sectional retrospective study utilized data on adverse paragliding events on Mount Babadağ in Turkey, collected by the Muğla Sports Tourism Board (STB) between January 2020 and December 2021, with data sources including out-of-hospital STB forms and in-hospital electronic health records.

RESULTS

Out of 241,420 paragliding flights, a total of 44 accidents were identified, with only three resulting in fatalities. Most of the accidents occurred during take off and landing, but the deadliest phase was during flight. The majority of accidents were of low severity, with a median National Advisory Committee for Aeronautics score of 1 (interquartile range [IQR] 1-3) and a median injury severity score of 1 (IQR 1-7.75). The lower limb was the most commonly injured body part, accounting for 55.8% of injuries, followed by the upper limb at 30.8%.

CONCLUSIONS

Despite being considered an extreme sport, paragliding carries a relatively low risk of accidents and serious injuries, owing to advancements in training, equipment inspection, and protective gear.

Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports

INTRODUCTION

Extreme sports (ESs) are increasingly popular, and accidents due to ESs sometimes require helicopter emergency medical services (HEMSs). Little is known about their epidemiology, severity, specific injuries and required rescue operations.

AIM

Our aims were to perform an epidemiological analysis, to identify specific injuries and to describe the characteristic of prehospital procedures in ES accidents requiring HEMSs.

METHODS

This is a retrospective study, reviewing all rescue missions dedicated to ESs provided by HEMS REGA Lausanne, from 1 January 1998 to 31 December 2008. ES were classified into three categories of practice, according to the type of risk at the time of the fall.

RESULTS

Among the 616 cases meeting inclusion criteria, 219 (36%) were clearly high-risk ES accidents; 69 (11%) and 328 (53%) were related to potential ES, but with respectively low or indeterminate risk at the time of the fall. In the high-risk ES group, the median age was 32 years and 80% were male. Mortality at 48h was 11%, almost ten times higher than in the other two groups. The proportion of potentially life-threatening injuries (the National Advisory Committee for Aeronautics (NACA) score≥4) was 39% in the high-risk ES group and 13% in the other two groups. Thirty per cent of the cases in the high-risk ES group presented an Injury Severity Score (ISS) >15, compared with 7% in the other groups. Thoracolumbar vertebral fractures were the most common injuries with 32% of all cases having at least one, involving the T12-L2 junction in 56% of cases. The other most frequent injuries were traumatic brain injuries (16%), rib fractures (9%), pneumothorax (8%) and femoral (7%), cervical (7%), ankle (5%) and pelvic (5%) fractures. Median time on site for rescue teams was higher in the confirmed high-risk ES group, with 50% of prehospital missions including at least one environmental difficulty.

CONCLUSIONS

High-risk ESs led to high-energy accidents, characterized by a large proportion of severe injuries and axial traumas (spine, thorax, pelvis and proximal femur). We identified a considerable percentage of thoracolumbar vertebral fractures, mainly in the T12-L2 junction. HEMSs dedicated to high-risk ESs implied longer and more complex interventions.

Characteristics of injuries caused by paragliding accidents: A cross-sectional study

BACKGROUND

This study was undertaken to analyze the characteristics and risk factors relating to fatalities and injuries caused by paragliding.

METHODS

The judicial examination reports and hospital documents of 82 patients traumatized in 64 accidents during 242 355 paragliding jumps between August 2004 and September 2011 were analyzed.

RESULTS

In these accidents, 18 of the 82 patients lost their lives. In the patients with a confirmed cause of accident, most of them were involved with multiple fractures and internal organ injuries (n=8, 44.4%).

CONCLUSION

We investigated the incidence of paragliding injuries, the types of the injuries, and the severity of affected anatomical regions. The findings are significant for the prevention of paragliding injuries and future research.

Accidents and injuries related to powered paragliding: a cross-sectional study

OBJECTIVES

Powered paragliding (PPG) and paragliding are two totally different sports, mainly because of the use of an engine in powered paragliding. As a consequence, the pattern of injuries caused by each of these two sports may be different.

SETTING

To test this hypothesis, we analysed 384 incident reports gathered by the US Powered Paragliding Association from 1995 to 2012. The majority of the incidents occurred in the USA, while 26 incidents occurred elsewhere: Canada (8), Mexico (5), Panama (1), China (1), Japan (1), Malaysia (1), Indonesia (Java) (1), Europe (8): of which Spain (1), Belgium (1), UK (3), Italy (1), Romania (1), unknown (1).

OUTCOME

To identify the most affected body area and the most common type of injury sustained in PPG, and to highlight any differences from paragliding.

RESULTS

The most affected body areas in PPG were the upper limbs (44.5%), followed by the lower limbs (32%), the back (9.8%), the head (7%), the pelvis (3.1), the chest (2.7%) and the abdomen (0.7%) (p<0.001). The engine caused 43 accidents (11.2%) in our study and was responsible for the majority of injuries to the upper limbs. The number of fatal accidents in PPG is not lower than in paragliding and hang-gliding.

CONCLUSIONS

To help prevent the specific injuries of PPG, the most appropriate equipment should be identified. The results of this study also suggest that, in the future, this sport should be analysed separately from paragliding.

A fatal case of anaphylactic shock during paragliding

The growth in popularity of flying ultralight aircraft and paragliding has been associated with an increased involvement of Emergency Medical Services because of various types of trauma suffered from both inexperienced and skilled individuals. This case presentation reports on a paraglider pilot, who was seen spinning "unusually" rapidly toward the ground, without visible attempts to regain control of the aircraft. Besides the bilateral mydriasis and the absence of any ECG activity, there was a significant swelling of face, lips, neck, and tongue. Upon opening the mouth, a dead bee was found over the tongue, underneath the palate. A fatal anaphylactic shock was the likely cause of death of the pilot while still "in mid-air." This case is certainly different from the commonly reported accidents during paragliding. An updated review of the medical literature shows no reported cases of fatal anaphylactic shock during the practice of paragliding.

Spinal and pelvic injuries in airborne sports: a retrospective analysis from a major Swiss trauma centre

BACKGROUND

Adrenalin-seeking airborne sports like BASE-jumping, paragliding, parachuting, delta-gliding, speedflying, and skysurfing are now firmly with us as outdoor lifestyle activities and are associated with a high frequency of severe injuries, especially to the spine.

METHODS

Retrospective analysis of all airborne sports-associated spinal and pelvic injuries admitted to a Level I trauma centre in the Swiss Alps between 1st March 2000 and 31st October 2009. Spinal injuries were classified by the Magerl system and pelvic injuries by the AO/OTA scheme modified by Isler and Ganz. Spino-pelvic dissociation fractures in airborne sports were compared to similar injuries in the general trauma population using multiple logistic regression analysis.

RESULTS

181 patients (11 BASE-jumpers, 144 paragliders, 19 parachuters, 1 speedflyer, 4 deltagliders, 2 skysurfer) were included. 161 (89%) were male. Median age was 37.0 years (IQR=29.0-47.0) and ISS 8 (IQR=4-13). 89 (49.2%) patients sustained spinal fractures. Type A fractures were predominant (91.5%), followed by Type C (5.3%) and Type B (3.2%). The level L1 was most often affected (35.1%). 17 patients (9.4%) had pelvic ring fractures. Most frequent were Type C fractures (41.2%), followed by Types A and B (29.4% each). 8 paragliders (4.4%) suffered spino-pelvic dissociation injuries. The odds ratio for sustaining such fractures in paragliders was 21-fold higher (OR 21.04, 95% CI 7.83-56.57, p<0.001) than in the general trauma population.

CONCLUSIONS

Serious spinal and pelvic injuries account for most injuries sustained during airborne sporting activities. The thoracolumbar region was most often affected, but the lumbopelvic junction is also especially vulnerable as high impact forces from vertical and horizontal deceleration need to be absorbed. The frequency of spino-pelvic dissociation was very high in paragliding injuries, with a 21-fold higher odds ratio than in the general trauma population.

[Injury patterns and typical stress situations in paragliding]

Paragliding is known as a high risk sport with a substantial rate of severe and fatal injuries. Analysis of typical injury mechanisms and statistics showed that the total rate of paragliding injuries has decreased in recent years for an increasing number of pilots. In 2003, the rate of severe and fatal injuries in paragliding was less than that of other air sports and motorcycling. Through the introduction of a spine protector system in Germany and Austria, the number of vertebral fractures decreased significantly between 2000 and 2003. Most other injuries, especially of the lower extremities, could be avoided by adequate and farsighted flight behavior. Qualified instruction with regular training, standardized development of safety equipment and consequent analysis of paragliding injuries will help to improve the safety status in paragliding.