1
|
Kelley N, Pierpoint L, Saeedi A, Hellwinkel JE, Khodaee M. An Epidemiologic Comparison of Injuries to Skiers and Snowboarders Treated at United States Emergency Departments, 2000-2019. Int J Sports Med 2024; 45:382-389. [PMID: 38190979 DOI: 10.1055/a-2240-7747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Skiing and snowboarding are popular competitive and recreational sports that can be associated with significant injury. Previous studies of skiing and snowboarding injuries have been conducted, but studies evaluating injury types and patterns over long periods of time are needed to drive effective injury prevention efforts. We hypothesized that injury patterns would differ among snowboarders and skiers and that the number of injuries remained constant over time. This is a retrospective study of patients presenting with skiing or snowboarding injuries to the United States emergency departments from 2000 to 2019. A total of 34,720 injured skiers (48.0%) and snowboarders (52.0%) presented to US emergency departments over a 20-year period, representing an estimated 1,620,576 injuries nationwide. There is a decreasing trend of the number of injuries over the study period (p=0.012). Males represented the majority (65.7%) of injuries. Skiers were older than snowboarders (mean 30.1 vs. 20.0 years; p<0.001) and patients aged<18 represented more snowboarding (57.0%) than skiing (43.0%) injuries (p<0.001). Common diagnoses included fractures (33.0%) and sprains/strains (26.9%). Snowboarders primarily presented with upper extremity injuries, meanwhile, skiers primarily presented with lower extremity injuries. Most patients (93.2%), were treated and discharged from the emergency departments. Understanding the epidemiology of injuries presenting to emergency departments can help guide prehospital care and medical coverage allocation for resorts and event organizers, as well as identifying areas for targeted injury prevention efforts.
Collapse
Affiliation(s)
- Naomi Kelley
- Medicine, University of Colorado School of Medicine, Aurora, United States
| | - Lauren Pierpoint
- Physical Medicine and Rehabilitation, University of Utah Health, Salt Lake City, United States
| | - Anahita Saeedi
- Biostatistics, University of Massachusetts Amherst, Amherst, United States
| | - Justin E Hellwinkel
- Orthopaedics, Columbia University Irving Medical Center, New York, United States
| | - Morteza Khodaee
- Family Medicine, University of Colorado Denver School of Medicine, Aurora, United States
| |
Collapse
|
2
|
Ekhator C, Bellegarde SB, Nduma BN, Qureshi MQ, Fonkem E. The Spine is the Tree of Life: A Systematic Review and Meta-Analysis of the Radiographic Findings Related to Spinal Injuries in Athletes. Cureus 2024; 16:e58780. [PMID: 38784300 PMCID: PMC11111419 DOI: 10.7759/cureus.58780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/25/2024] Open
Abstract
This review article explores spinal injuries in athletes participating in various sporting activities. It also highlights the various mechanisms of injuries that contribute to spinal injuries in each sport. Electronic databases such as PubMed, Cochrane Library, Web of Science, Embase, MEDLINE Ovid, and Google Scholar were searched for articles from 2000 to 2022 on spine injuries in sports and radiological studies discussing the various injury patterns among athletes. Studies were scoured in accordance with the inclusion criteria, and relevant data such as the number of participants, sporting activities, spine injuries, and outcomes were retrieved. Fifteen articles that met the inclusion criteria were included in the study. Cervical spine injuries are common in athletes who participate in contact sports such as football. Similarly, athletes in collision sports such as football, rugby, and hockey are likely to suffer stingers due to traction and compression injuries. Players engaged in such as soccer, baseball, and swimming, are likely to suffer from spondylolysis. Soccer players are more prone to multiple lesions compared to athletes in sports such as baseball because the sport involves training exercises such as jogging and running without kicking any ball. In swimmers, spondylolysis is common in breaststroke and butterfly styles since they involve repeated flexion and hyperextension of the lumbar spine. CT is essential for diagnosing spondylolysis as it demonstrates the lesions more accurately. Ice hockey is associated with a significant incidence of cervical spine injuries, mostly due to players being constantly checked/pushed from behind. Spine injuries are common in elite athletes across several sports. About 10% of spinal injuries in the United States result from sports activities. In diagnosing spine injuries, imaging modalities such as MRI, CT, or plain radiographs are essential. From a radiologist's perspective, these tests help immensely in deciding which treatment is required for a particular athlete or how the injury can be optimally managed. Achieving recovery from a specific spine injury usually depends on the kind of injury and the rehabilitation process the athletes undergo before returning to play.
Collapse
Affiliation(s)
- Chukwuyem Ekhator
- Neuro-Oncology, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, USA
| | - Sophia B Bellegarde
- Pathology and Laboratory Medicine, American University of Antigua, St. John's, ATG
| | - Basil N Nduma
- Internal Medicine, Medical City Hospital, Denton, USA
| | | | - Ekokobe Fonkem
- Neuro-Oncology, Barrow Neurological Institute, Phoenix, USA
| |
Collapse
|
3
|
Yoshimura G, Kamidani R, Yasuda R, Miura T, Yamaji F, Mizuno Y, Kitagawa Y, Fukuta T, Ishihara T, Suzuki K, Miyake T, Nagaya S, Kanda N, Doi T, Okada H, Yoshida T, Yoshida S, Ogura S. Clinical characteristics of patients with snow sports trauma transported to a trauma care center: A retrospective observational study. Injury 2022; 54:1379-1385. [PMID: 36639253 DOI: 10.1016/j.injury.2022.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/08/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Snow sports are a popular recreational activity; however, the incidence of injury of snow sports can be high for skiers and snowboarders. Our hospital receives severe trauma cases from snow resorts and hospitals throughout the region. This study aimed to determine whether the risk of snow sports-related major trauma that requires emergency surgery under general anesthesia varies by the equipment and injury mechanism. METHODS This retrospective cohort study included patients with snow sports trauma referred to Gifu University Hospital, Japan between November 2010 and March 2020. We analyzed the need for emergency operation under general anesthesia within 24 h using Fisher's exact test. We identified 106 patients: (1) 90 in the snowboarders' group and 16 in the skiers' group or (2) 46 in the fall after jumping group (jumping group), 27 in the collide with other people and obstacle group (collision group), and 33 in the fall during gliding group (gliding group). RESULTS Snowboarders were nearly twice as likely as skiers to require emergency surgery under general anesthesia (44% vs. 25%; p = 0.236]. No significant associations were found between emergency surgery under general anesthesia and injury mechanism, but half of the patients in the jumping group required emergency surgery. CONCLUSIONS Snowboard as equipment and falls after jumping as a mechanism of injury tended to be associated with emergency surgery under general anesthesia, with no significant differences. In order to provide adequate resources for snow sports trauma, the cause of the patient's injury is strongly related to the urgency of the condition, and transport to a trauma center should be actively considered. Further studies are warranted with respect to the effects of personal protective equipment and skill level.
Collapse
Affiliation(s)
- Genki Yoshimura
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Ryo Kamidani
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan; Abuse Prevention Center, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Ryu Yasuda
- Department of Emergency, Gifu Municipal Hospital, Gifu, Japan
| | - Tomotaka Miura
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Fuminori Yamaji
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Yosuke Mizuno
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Yuichiro Kitagawa
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Tetsuya Fukuta
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Kodai Suzuki
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Takahito Miyake
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Soichiro Nagaya
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Norihide Kanda
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Tomoaki Doi
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Hideshi Okada
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Takahiro Yoshida
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Shozo Yoshida
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan; Abuse Prevention Center, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shinji Ogura
- Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| |
Collapse
|
4
|
Soares S, Schmid T, Delsa L, Gallusser N, Moor BK. Skiing and snowboarding related deep laceration injuries. A five-season cross-sectional analysis from a level-1 trauma centre in the Swiss Alps. Orthop Traumatol Surg Res 2022; 108:103370. [PMID: 35868488 DOI: 10.1016/j.otsr.2022.103370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/05/2022] [Accepted: 04/25/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Lacerations comprise 5.6-33.6% of skiing/snowboarding related injuries. This study aimed to investigate the mechanism of injury and the location of these lacerations and propose preventive measures. METHODS After our state ethics committee approval, we retrospectively reviewed the medical records and surgical protocols of 46 patients (mean age (±SD) 34.6 (±15.3); 71.4% men) treated for severe skiing/snowboarding lacerations at our level-1 trauma centre between 2016 and 2021. Patients were asked to answer a questionnaire on their skiing experience, equipment used and the circumstances of the accident. RESULTS Lacerations around the hip, thigh, and knee accounted for 94%. The latter was the most common location (45%). Although 91.3% of patients wore appropriate clothing and full standard protection equipment, it did not offer any extra-resistance against skiing/snowboarding's edges. Skiers were more affected (91.3%) than snowboarders (8.7%). The most common mechanism of injury was inadvertent release of the bindings (52.2%), followed by insufficient ski level for the slope (21.7%) and collisions (17.4%). Long-term trends demonstrated an increasing incidence. CONCLUSION Identification of body areas at risk and the mechanisms of injury were the most significant findings of this work. These data encourage the development of specific injury prevention programs as the occurrence of these lesions tended to increase over the last few years. To reduce their incidence, we propose skiers to have their bindings regularly adjusted and manufacturers to develop cut-resistant skiwear. LEVEL OF EVIDENCE IV.
Collapse
|
5
|
Emergency Service Assistance for Injuries on Alpine Ski Slopes: A Cross-Sectional Study. Prehosp Disaster Med 2022; 37:778-782. [PMID: 36199228 DOI: 10.1017/s1049023x22001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Injuries on alpine ski slopes have been described in cohorts of a reasonable sample size, but constant improvements in safety gear, increased use of airborne rescue, and safety measures during the coronavirus disease 2019 (COVID-19) pandemic mandate re-evaluation. Therefore, the purpose of this study was to evaluate skiing and snowboarding injuries, effectiveness of airborne rescue, and impact of the COVID-19 pandemic on a large sample size. METHODS Data on alpine injuries were prospectively collected from the state emergency services dispatch center in the state of Tyrol (Austria). A total of 10,143 patients were identified, with an average age of 33.5 years (SD = 20.36). The ski patrol was involved in 8,606 cases (84.9%) and some patients (n = 1,536; 15.1%) required helicopter rescue. RESULTS A total of 10,143 patients were identified from the dataset of the emergency dispatch center. The most frequently injured region was the knee (30.2%), and it was followed by the shoulder (12.9%), the lower leg (9.5%), and the head/skull (9.5%). CONCLUSION The present findings indicate that the most frequent site of injuries on alpine slopes is the knee, and life-threatening injuries are rare. Airborne rescue is very time-effective, however clinical studies with patient follow-up should be emphasized to determine the impact of airborne rescue on patient outcome. The present findings indicate that the duration of all rescue operations has been prolonged as a result of the introduction of safety measures during the COVID-19 pandemic.
Collapse
|
6
|
Huffman WH, Jia L, Pirruccio K, Li X, Hecht AC, Parisien RL. Acute Vertebral Fractures in Skiing and Snowboarding: A 20-Year Sex-Specific Analysis of National Injury Data. Orthop J Sports Med 2022; 10:23259671221105486. [PMID: 35837441 PMCID: PMC9274405 DOI: 10.1177/23259671221105486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The epidemiology of acute vertebral fractures (AVFs) sustained while skiing
and snowboarding remains poorly defined in the United States. Hypothesis: It was hypothesized that there would be no significant differences across sex
and a greater number of AVFs in younger age groups associated with skiing
and snowboarding. Study Design: Descriptive epidemiological study. Methods: The authors utilized the National Electronic Injury Surveillance System to
identify patients who were reported in emergency departments in the United
States from 2000 to 2019. All patients were noted to have sustained AVFs
during skiing or snowboarding. National estimates and demographic analysis
were performed. Results: A total of 466 AVFs were identified, or roughly 23.3 AVFs per year. Compared
with women, men accounted for the majority of AVFs sustained in both skiing
and snowboarding: 67.8% (95% CI, 62.6%-73.0%) during skiing and 82.1% (95%
CI, 76.3%-87.8%) during snowboarding. This represented a significantly
larger percentage of AVFs while snowboarding compared with skiing
(P = .002). Women accounted for 32.2% (95% CI,
27.0%-37.4%) of AVFs while skiing and 17.9% (95% CI, 12.2%-23.7%) while
snowboarding, which indicated a significantly larger percentage of AVFs
sustained during skiing compared with snowboarding (P =
.002). Snowboarders were more likely than skiers to sustain an AVF in the
region of the coccyx (21.5% [95% CI, 14.3%-28.7%] vs 11.5% [95% CI,
3.5%-16.9%], respectively; P = .003) and as a result of a
fall at ground level (69.2% [95% CI, 62.1%-76.4%] vs 52.8% [95% CI,
43.2%-62.4%], respectively; P = .009). A significant
decrease in the number of snowboarding-related AVFs was identified over the
20-year study period: 899 in 2000-2003 versus 283 in 2016-2019
(P < .01). The change in skiing-related AVFs over
the study period was not statistically significant (694 vs 462;
P = .5). Conclusion: This national study of AVFs sustained while skiing and snowboarding
identified critical sex- and age-specific differences in the population at
risk, anatomic location of injury, and mechanism of injury. The national
data generated from this study over a 20-year period may be utilized to
better inform public health injury awareness and prevention initiatives in
the rapidly growing sports of skiing and snowboarding.
Collapse
Affiliation(s)
- William H Huffman
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lori Jia
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kevin Pirruccio
- Department of Orthopaedic Surgery, Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Xinning Li
- Boston University Medical Center, Boston, Massachusetts, USA
| | - Andrew C Hecht
- Department of Orthopaedic Surgery, Mount Sinai, New York, New York, USA
| | - Robert L Parisien
- Department of Orthopaedic Surgery, Mount Sinai, New York, New York, USA
| |
Collapse
|
7
|
Holden WM, Barnum MS, Tarka MC, Niederhauser CA, Jewell RP, Endres NK. Severe Lacerations in Alpine Ski Racing: A Case Series and Review of the Literature. Sports Health 2022; 15:142-147. [PMID: 35354392 PMCID: PMC9808826 DOI: 10.1177/19417381221076521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
STUDY DESIGN Case series. LEVEL OF EVIDENCE Level 4C.
Collapse
Affiliation(s)
- William M. Holden
- The Larner College of Medicine,
University of Vermont, Department of Orthopaedics and Rehabilitation, Burlington,
Vermont
| | - Michael S. Barnum
- The Larner College of Medicine,
University of Vermont, Department of Orthopaedics and Rehabilitation, Burlington,
Vermont
| | - Mitchell C. Tarka
- The Larner College of Medicine,
University of Vermont, Department of Orthopaedics and Rehabilitation, Burlington,
Vermont
| | - Christoph A. Niederhauser
- The Larner College of Medicine,
University of Vermont, Department of Orthopaedics and Rehabilitation, Burlington,
Vermont
| | - Ryan P. Jewell
- Division of Neurosurgery, Department of
Surgery, The Larner College of Medicine, University of Vermont, Burlington,
Vermont
| | - Nathan K. Endres
- The Larner College of Medicine,
University of Vermont, Department of Orthopaedics and Rehabilitation, Burlington,
Vermont,Nathan K. Endres, MD, The
Larner College of Medicine, University of Vermont, Department of Orthopaedics
and Rehabilitation, McClure Musculoskeletal Research Center, 95 Carrigan Drive,
402 Stafford Hall, Burlington, VT 05405 (
)
| |
Collapse
|
8
|
Bohyn C, Flores DV, Murray T, Mohr B, Cresswell M. Imaging Review of Snowboard Injuries. Semin Musculoskelet Radiol 2022; 26:54-68. [PMID: 35139559 DOI: 10.1055/s-0041-1731702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Snowboarding and skiing remain the two most popular winter sports worldwide. Musculoskeletal (MSK) injuries are common in snowboarding, and the number has increased significantly since the advent of snow parks. The number of injuries is the highest for novice snowboarders; more experienced boarders generally sustain more severe injuries. Snowboarders can experience a wide array of MSK injuries, but some injury types are more frequently encountered because of the specific injury mechanism unique to snowboarding. This article reviews the most common snowboarding injuries with a focus on the current understanding of the injury mechanism and provides an approach to imaging.
Collapse
Affiliation(s)
- Cedric Bohyn
- Department of Radiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dyan V Flores
- Department of Radiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.,Institute of Radiology, St. Luke's Medical Center Global City, Metro Manila, Philippines
| | - Timothy Murray
- Department of Radiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruce Mohr
- Whistler Health Care Center, Whistler, British Columbia, Canada
| | - Mark Cresswell
- Department of Radiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
9
|
Flores DV, Murray TÉ, Bohyn C, Mohr B, Cresswell M. Imaging Review of Alpine Ski Injuries. Semin Musculoskelet Radiol 2022; 26:41-53. [PMID: 35139558 DOI: 10.1055/s-0041-1731794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Skiing is a continuously evolving winter sport, responsible for a considerable number of musculoskeletal injuries. Specific injury patterns and mechanisms in the upper and lower extremities, head, and spine are influenced by skier expertise and skill, position during injury, and environmental conditions. Predilection for certain joints and injury patterns have changed over time, largely due to technological advancements in equipment, increased awareness campaigns, and preventive protocols. Knowledge and understanding of these trends and developments can aid the radiologist to reach a timely and accurate diagnosis, thereby guiding clinical management and potentially reducing the overall incidence of debilitation and death.
Collapse
Affiliation(s)
- Dyan V Flores
- Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Timothy É Murray
- Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cedric Bohyn
- Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Radiology, AZ Monica, Antwerpen, Belgium
| | - Bruce Mohr
- Whistler Health Care Center, Whistler, British Columbia, Canada
| | - Mark Cresswell
- Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
10
|
Efficacy of Helmet Use on Head Injury Reduction in Snow Sports: A Critically Appraised Topic. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2022. [DOI: 10.1123/ijatt.2022-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Context: Review articles published in 2010 concluded that there was strong evidence to support the use of helmets as a way to decrease the risk of sustaining a head injury during snow sport participation. However, new research published over the last decade on this relationship warrants revisiting this primary injury prevention approach. Clinical Question: What is the effect of helmet use on the occurrence of head injuries in snow sports? Clinical Bottom Line: The results from the included studies did not consistently find a reduction in head injury occurrence with helmet use in snow sports. Rather, the collective findings were more supportive of a neutral relationship between helmet use and head injuries. Therefore, these heterogeneous findings indicate there is SORT Level B evidence to support the use of helmets as a primary head injury prevention approach in snow sports. Future initiatives should acknowledge the multifaceted nature of injury occurrence and seek to educate the public more clearly on the limitations of helmet use during skiing and snowboarding.
Collapse
|
11
|
Fu XL, Du L, Song YP, Chen HL, Shen WQ. Incidence of injuries in professional snow sports: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:6-13. [PMID: 33130094 PMCID: PMC8847944 DOI: 10.1016/j.jshs.2020.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/11/2020] [Accepted: 08/24/2020] [Indexed: 06/01/2023]
Abstract
PURPOSE The study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders. METHODS We systematically searched PubMed, Web of Science, and MEDLINE for studies on injury incidence published from inception to April 2020. Injury data were extracted, alongside information on injury location, severity, type, cause, and sport discipline. Incidence of injuries was presented per 1000 athlete-days, with 95% confidence intervals (95%CIs). RESULTS The search identified 462 articles, and 22 were included in our review. The overall incidence of injuries among professional skiers and snowboarders was 3.49 per 1000 athlete-days (95%CI: 2.97-4.01). Lower extremity had the highest injury incidence (1.54 per 1000 athlete-days, 95%CI: 1.24-1.84). Incidence rates of slight, mild, moderate, and severe injuries were 0.26, 0.31, 0.57, and 0.59 per 1000 athlete-days, respectively. Contusion had the highest incidence rate (1.82 per 1000 athlete-days, 95%CI: 1.01-2.63). The most common cause of injury was contact trauma (3.20 per 1000 athlete-days, 95%CI: 1.32-5.08). Freestyle skiing had the highest incidence rate (6.83 per 1000 athlete-days, 95%CI: 4.00-9.66), and Nordic skiing had the lowest rate (2.70 per 1000 athlete-days, 95%CI: 1.94-3.46). CONCLUSION Professional skiers and snowboarders have a substantial risk of sustaining injuries. Our findings can be used to inform the planning and provision of healthcare for elite participants in different snow sports.
Collapse
Affiliation(s)
- Xue-Lei Fu
- School of Medicine, Nantong University, Nantong 226001, China
| | - Lin Du
- School of Medicine, Nantong University, Nantong 226001, China
| | - Yi-Ping Song
- School of Medicine, Nantong University, Nantong 226001, China
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong 226019, China.
| | - Wang-Qin Shen
- School of Medicine, Nantong University, Nantong 226001, China.
| |
Collapse
|
12
|
Turbans vs. Helmets: A Systematic Narrative Review of the Literature on Head Injuries and Impact Loci of Cranial Trauma in Several Recreational Outdoor Sports. Sports (Basel) 2021; 9:sports9120172. [PMID: 34941810 PMCID: PMC8703542 DOI: 10.3390/sports9120172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/03/2021] [Accepted: 12/15/2021] [Indexed: 12/28/2022] Open
Abstract
When in public, faith-based mandates require practising Sikh men to wear a turban which may not be covered by hats or caps. This makes it impossible for practising Sikhs to wear helmets and other protective headwear, mandatory in many countries and facilities for engagement in recreational pursuits (e.g., skiing) and on adventure outdoor recreation camps mandatorily run for school groups. The result is often social exclusion and ostracisation in the case of school children. Despite studies into the efficacy of protective helmets in some recreational outdoor activity settings, virtually nothing is known about the protective potential of turbans. This paper systematically reviews the extant literature on head injuries in several recreational outdoor activities and sports sectors (aerial, water, winter, wheeled and animal-based sports) and finds that the extant literature is of limited value when trying to understand the spatial distribution of trauma on the cranial surface. As the data do not permit to make inferences on the protective potential of turbans, future systematic, evidence-based epidemiological studies derived from hospital admissions and forensic examinations are required. Failure to do so perpetuates social exclusion and discrimination of religious grounds without an evidentiary basis for defensible public health measures.
Collapse
|
13
|
Maat SC, Luppino FS, Schipper IB, Krijnen P, Bartlema KA. Injury patterns after skiing and snowboarding sports accidents. J Sports Med Phys Fitness 2019; 60:119-124. [PMID: 31640310 DOI: 10.23736/s0022-4707.19.09753-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Alpine sports are associated with risk of serious injuries. To gain insight into factors that may help reduce injury severity, accident characteristics and injury patterns were analyzed in a cohort of injured skiers and snowboarders. METHODS All patients with Alpine sports-related injuries, reporting the injury to a leading medical assistance organization in the Netherlands in the period of 2013-2016, were contacted. Medical data were collected from the patients' files. Only ski and snowboard incidents were included. Injuries were classified according to the Abbreviated Injury Scale (AIS) and Injury Severity Scale (ISS). Data on the accident conditions, i.e. risk factors, were collected using retrospective patient-reported questionnaires. Risk factors for injuries with ISS≥9 were analysed by multivariate modelling. RESULTS Of the 1588 included patients, 421 patients filled out the questionnaire. Skiers (N.=1370) had more knee injuries (20.4% vs. 7.4%, P<0.001), femur fractures (5.3% vs. 0.5%, P=0.002) and lower leg fractures (27.5% vs. 11.5%, P<0.001) compared to snowboarders (N.=218). Skiers were also more seriously injured (ISS>9) (P=0.01). Injured snowboarders sustained more brain concussions (8.8% vs. 15.7%, P=0.003) and lower arm fractures (5.4% vs. 16.1%, P<0.001). Only 'a higher skills level' was borderline significant for predicting serious injury (OR: 4.0 95% CI: 0.86-18.50; P=0.08). No additional risk factors were identified. CONCLUSIONS Injury patterns after skiing and snowboarding accidents differ, injury severity differed not. Preventive measures should therefore aim to protect specific body parts depending on the type of Alpine sport. Experienced skiers and snowboarders may be more at risk for serious injuries.
Collapse
Affiliation(s)
- Sanne C Maat
- Department of Trauma Surgery, Leiden University Medical Centre, Leiden, the Netherlands -
| | | | - Inger B Schipper
- Department of Trauma Surgery, Leiden University Medical Centre, Leiden, the Netherlands
| | - Pieta Krijnen
- Department of Trauma Surgery, Leiden University Medical Centre, Leiden, the Netherlands
| | - Kornelis A Bartlema
- Department of Trauma Surgery, Leiden University Medical Centre, Leiden, the Netherlands
| |
Collapse
|
14
|
Pierpoint LA, Kerr ZY, Grunwald G, Khodaee M, Crume T, Comstock RD. Effect of environmental conditions on injury rates at a Colorado ski resort. Inj Prev 2019; 26:324-329. [PMID: 31324655 DOI: 10.1136/injuryprev-2019-043275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine the effect of daily environmental conditions on skiing and snowboarding-related injury rates. METHODS Injury information was collected from a mountainside clinic at a large Colorado ski resort for the 2012/2013 through 2016/2017 seasons. Daily environmental conditions including snowfall, snow base depth, temperature, open terrain and participant visits were obtained from historical resort records. Snowpack and visibility information were obtained for the 2013/2014 through 2014/2015 seasons and included in a subanalysis. Negative binomial regression was used to estimate injury rate ratios (IRRs) and 95% CIs. RESULTS The overall injury rate among skiers and snowboarders was 1.37 per 1000 participant visits during 2012/2013 through 2016/2017. After adjustment for other environmental covariates, injury rates were 22% higher (IRR=1.22, 95% CI 1.14 to 1.29) on days with <2.5 compared with ≥2.5 cm of snowfall, and 14% higher on days with average temperature in the highest quartile (≥-3.1°C) compared with the lowest (<-10.6°C; IRR=1.14, 95% CI 1.03 to 1.26). Rates decreased by 8% for every 25 cm increase in snow base depth (IRR=0.92, 95% CI 0.88 to 0.95). In a subanalysis of the 2013/2014 and 2014/2015 seasons including the same covariates plus snowpack and visibility, only snowpack remained significantly associated with injury rates. Rates were 71% higher on hardpack compared with powder days (IRR=1.71, 95% CI 1.18 to 2.49) and 36% higher on packed powder compared with powder days (IRR 1.36, 95% CI 1.12 to 1.64). CONCLUSIONS Environmental conditions, particularly snowfall and snowpack, have a significant impact on injury rates. Injury prevention efforts should consider environmental factors to decrease injury rates in skiers and snowboarders.
Collapse
Affiliation(s)
- Lauren A Pierpoint
- Epidemiology, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Zachary Y Kerr
- Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Gary Grunwald
- Biostatistics and Informatics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Morteza Khodaee
- Family Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Tessa Crume
- Epidemiology, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| | - R Dawn Comstock
- Epidemiology, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA
| |
Collapse
|
15
|
Ball JR, Harris CB, Lee J, Vives MJ. Lumbar Spine Injuries in Sports: Review of the Literature and Current Treatment Recommendations. SPORTS MEDICINE-OPEN 2019; 5:26. [PMID: 31236714 PMCID: PMC6591346 DOI: 10.1186/s40798-019-0199-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/07/2019] [Indexed: 11/22/2022]
Abstract
Low back pain is one of the most prevalent complaints of athletes at all levels of competition. The purpose of this literature review is to provide an overview of sport-specific injuries and treatment outcomes that can be used by healthcare providers to better recognize injury patterns and treatment options for different groups of athletes. To our knowledge, no prior comprehensive review of lumbar spine injuries in sports is currently available in the literature, and it is essential that healthcare providers understand the sport-specific injury patterns and treatment guidelines for athletes presenting with low back pain following an athletic injury. Injury mechanisms were found to vary significantly by sport, although some broad recommendations can be made with regards to optimal treatment for these injuries and return to play. Additionally, it was found that certain treatments were more beneficial and resulted in higher rates of return to play depending on the specific sport of the injured athlete. Healthcare providers need to be aware of the different injury patterns seen in specific sports in order to properly evaluate and treat these injuries. Furthermore, an individualized treatment plan needs to be selected in a sport-specific context in order to meet the needs of the athlete in the short and long term.
Collapse
Affiliation(s)
- Jacob R Ball
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen St., ACC D1610, Newark, NJ, 07103, USA
| | - Colin B Harris
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen St., ACC D1610, Newark, NJ, 07103, USA.
| | - Jonathan Lee
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen St., ACC D1610, Newark, NJ, 07103, USA
| | - Michael J Vives
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen St., ACC D1610, Newark, NJ, 07103, USA
| |
Collapse
|
16
|
Abstract
To systematically review published literature on pediatric snowboard injuries, a literature search was performed in PubMed for "snowboard*". Studies must 1) have been primary research; 2) included at least 10 snowboarders; 3) included children and/or adolescents 4) reported specific injury outcomes, risk factors, or injury prevention program effectiveness. The overall injury rates ranged from 0.5 per 1,000 runs to 420 per 1,000 snowboarders. The most common injuries types were fractures, sprains and strains. Most injuries occurred to an upper extremity or the head. Falls and collisions were the most common mechanisms. Snowboarders who were younger, female, had less snowboard experience, or had a previous injury were at greater risk for injury. Wearing wrist guards had a protective effect. Injury rates varied by injury denominator and source of data. Injury prevention efforts should evaluate modifiable extrinsic risk factors, such as strategies to increase use of protective equipment.
Collapse
Affiliation(s)
- Kelly Russell
- a Pediatrics and Child Health , University of Manitoba , Winnipeg , Canada.,b Children's Hospital Research Institute on Manitoba , Winnipeg , Canada.,c Canada North Concussion Network , Winnipeg , Canada
| | - Erin Selci
- a Pediatrics and Child Health , University of Manitoba , Winnipeg , Canada.,b Children's Hospital Research Institute on Manitoba , Winnipeg , Canada
| |
Collapse
|
17
|
Helmig K, Treme G, Richter D. Management of injuries in snowboarders: rehabilitation and return to activity. Open Access J Sports Med 2018; 9:221-231. [PMID: 30349409 PMCID: PMC6188004 DOI: 10.2147/oajsm.s146716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Snowboarding has seen a continuous increase in popularity, leading to an increase in the number of snowboarding injuries seen in orthopedic practice. Upper-extremity injuries are more common than lower-extremity, spine, and pelvis injuries. In this review, we focus on the most common snowboarding injuries of the extremities, spine, and pelvis and provide an overview of their respective rehabilitation and return-to-sport protocols. Despite many of the injuries seen in snowboarding also occurring in other sports, objective data about rehabilitation and return to sport are lacking for many injuries. This provides an opportunity for research in the area with regard to many sports and many different injuries.
Collapse
Affiliation(s)
- Kathryn Helmig
- Department of Orthopaedic Surgery, University of New Mexico, Albuquerque, NM, USA,
| | - Gehron Treme
- Department of Orthopaedic Surgery, University of New Mexico, Albuquerque, NM, USA,
| | - Dustin Richter
- Department of Orthopaedic Surgery, University of New Mexico, Albuquerque, NM, USA,
| |
Collapse
|
18
|
Seleznev A, Shah NV, Desai R, Le C, Cleary P, Naziri Q, Basu NN, Freeman BJ, Urban WP, Newman JM. Trends of snowboarding-related fractures that presented to emergency departments in the United States, 2010 to 2016. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:200. [PMID: 30023363 DOI: 10.21037/atm.2018.04.32] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Since it was introduced as an Olympic sport in 1998, snowboarding has drawn the participation of individuals of all ages. Despite the growing popularity of this sport, individuals can suffer from a number of musculoskeletal injuries. The specific goals of the study were to: (I) compare the number of injuries and trends of snowboarding injuries; (II) identify the injury occurrences, trends, and incidence of snowboarding-related fractures; and (III) identify the injury occurrences and trends of snowboarding-related fractures by body part. Methods The National Electronic Injury Surveillance System (NEISS) database was queried for snowboarding injuries and snowboarding-related fractures treated in US emergency departments (EDs) from 2010-2016. The weighted estimate of the number of injuries were obtained by using the NEISS statistical weight calculations that were provided in the data. An estimated total of 248,388 patients (mean age =20 years) experienced a snowboarding-related injury. Linear regression analysis was used to analyze annual trends of snowboarding-related fractures and the snowboarding-related fractures by body part; reported as the correlation coefficient (r) and the coefficient of determination (R2). Results The estimated annual number of injuries decreased from 56,223 injuries in 2010 to 17,667 injuries in 2016 (r=-0.967, R2=0.936, P<0.001). The most common types of injuries were fractures (31.7%), strains/sprains (25.2%), contusions (10.9%), concussions (10.0%), internal injuries (7.2%), and dislocations (4.0%). From 2010 to 2016, the estimated annual number of fractures decreased from 18,757 in 2010 to 4,539 in 2016 (r=-0.978, R2=0.957, P<0.001), and the annual incidence of snowboarding-related fractures decreased by 23.1%. The most common location of snowboarding-related fractures was the upper extremity, more specifically the wrist (32.3%). There was a decrease in the estimated annual number of fractures of the wrist (r=-0.965, R2=0.932, P<0.001), forearm (r=-0.821, R2=0.861, P=0.023), shoulder (r=-0.872, R2=0.760, P=0.011), elbow (r=-0.901, R2=0.813, P=0.006), and lower leg (r=-0.929, R2=0.864, P=0.002). Conclusions With the growing popularity of snowboarding in the US, it is important to know the common types of injuries that occur. This study found that fractures were the most common injuries, especially of the upper extremity.
Collapse
Affiliation(s)
- Aleksey Seleznev
- Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Neil V Shah
- Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Rohan Desai
- Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Cuong Le
- Department of Family Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Patrick Cleary
- Department of Sports Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Qais Naziri
- Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Niladri N Basu
- Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Barbara J Freeman
- Department of Orthopaedic Surgery, Kings County Hospital Center, Brooklyn, New York, USA
| | - William P Urban
- Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Jared M Newman
- Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York, USA
| |
Collapse
|
19
|
Polites SF, Mao SA, Glasgow AE, Moir CR, Habermann EB. Safety on the slopes: ski versus snowboard injuries in children treated at United States trauma centers. J Pediatr Surg 2018; 53:1024-1027. [PMID: 29729772 DOI: 10.1016/j.jpedsurg.2018.02.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 02/01/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE Skiing and snowboarding are popular winter sports. The purpose of this study was to determine differences in injury patterns and severity between children participating in these sports treated at trauma centers in the United States. METHODS Ski and snowboard injuries in children <15 identified from the 2011-2015 National Trauma Data Bank were compared using t tests, chi squared tests, and multivariable analyses. Time trends were evaluated using the Cochran Armitage trend test. RESULTS We identified 1613 injured snowboarders and 1655 skiers. Snowboarders were older (12 vs. 11years, p<.001) and more likely to be male (84 vs. 68%, p<.001). The proportion of ski to snowboard injuries increased over time (p<.001). Skiers had greater median ISS than snowboarders (5 vs. 4, p<.001) but similar severe injuries ISS ≥16 (9 vs. 8%, p=.31). Head injuries were more frequent among snowboarders (26 vs. 23%, p=.013). Helmet use was greater in skiers (46 vs. 34%, p<.001). Skiers were more likely to sustain face, chest, and lower extremity injuries. Snowboarders had more abdominal and upper extremity injuries (p<.05). Snowboarders were more likely to undergo CT (20 vs. 16%, p=.008), and skiers were more likely to undergo surgery (25 vs. 22% p=.021). Need for intensive care (12 vs. 13%, p=.43) and mortality (0.3 vs. 0.3%, p=.75) were similar. Median length of stay was greater for skiers (2 days vs. 1day, p<.001). CONCLUSION Many children are treated at United States trauma centers for ski and snowboard injuries. One in 10 is severely injured. Different injury patterns between sports can be used to tailor prevention efforts. However, avoiding head injury and improving helmet use should be a priority for all children on the slopes. LEVEL OF EVIDENCE III TYPE OF STUDY: Prognostic.
Collapse
Affiliation(s)
| | - Shennen A Mao
- Department of Surgery, Mayo Clinic, Rochester, MN, United States
| | - Amy E Glasgow
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| | | | - Elizabeth B Habermann
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| |
Collapse
|
20
|
Provance AJ, Daoud AK, Tagawa A, Rhodes J. Pediatric and adolescent injury in skiing. Res Sports Med 2018; 26:150-165. [DOI: 10.1080/15438627.2018.1438282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Aaron J. Provance
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ariel K. Daoud
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Alex Tagawa
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jason Rhodes
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA
| |
Collapse
|
21
|
Siesmaa EJ, Clapperton AJ, Twomey D. Hospital-Treated Snow Sport Injury in Victoria, Australia: A Summary of 2003-2012. Wilderness Environ Med 2018; 29:194-202. [PMID: 29602608 DOI: 10.1016/j.wem.2018.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/25/2018] [Accepted: 01/26/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION To determine the incidence rate and changes over time for ice and snow sports injury in Victoria, Australia, from 2003 to 2012 and describe the most common types and causes of these injuries. METHODS Retrospective data from the Victorian Injury Surveillance Unit describing hospital admissions and emergency department presentations were extracted for the 10-year period of 2003 to 2012 for all ice- and snow-related injury. Descriptive injury data and participation-adjusted trend analyses using log-linear regression modelling of data (statistical significance, P<0.05) from the Exercise, Recreation and Sport Survey 2003 to 2010 are presented. RESULTS Overall, there were 7387 ice- and snow-related injuries, with a significant increase in hospital-treated snowboard injuries and a (nonsignificant) decline in hospital-treated ski injuries over the 10 years. Skiing (39%) and snowboarding (37%) had the highest incidence of hospital-treated injury, with males aged 15 to 24 years injured most frequently in both sports. Falls were the most common cause of injury in both skiing (68%) and snowboarding (78%). CONCLUSIONS Patterns of snow sports injury in Australia during 2003 to 2012 remain similar to findings of national studies conducted decades earlier. More importantly, however, Australian injury patterns are comparable to international statistics and thus may be generalizable internationally. Head injuries, although infrequent, are associated with great injury severity due to a high frequency of hospitalization. Furthermore, research into the use of personal protective equipment and other injury prevention measures among Australian participants, particularly by young, male snowboarders, is required. Given the similar injury patterns, injury prevention measures implemented internationally could reasonably translate to an Australian setting.
Collapse
Affiliation(s)
- Emma J Siesmaa
- School of Health Sciences and Psychology, Federation University Australia, Ballarat, Australia (Drs Siesmaa and Twomey).
| | - Angela J Clapperton
- Victorian Injury Surveillance Unit, Monash University, Melbourne, Australia (Ms Clapperton)
| | - Dara Twomey
- School of Health Sciences and Psychology, Federation University Australia, Ballarat, Australia (Drs Siesmaa and Twomey)
| |
Collapse
|
22
|
Gardner RC, Dams-O'Connor K, Morrissey MR, Manley GT. Geriatric Traumatic Brain Injury: Epidemiology, Outcomes, Knowledge Gaps, and Future Directions. J Neurotrauma 2018; 35:889-906. [PMID: 29212411 PMCID: PMC5865621 DOI: 10.1089/neu.2017.5371] [Citation(s) in RCA: 242] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This review of the literature on traumatic brain injury (TBI) in older adults focuses on incident TBI sustained in older adulthood ("geriatric TBI") rather than on the separate, but related, topic of older adults with a history of earlier-life TBI. We describe the epidemiology of geriatric TBI, the impact of comorbidities and pre-injury function on TBI risk and outcomes, diagnostic testing, management issues, outcomes, and critical directions for future research. The highest incidence of TBI-related emergency department visits, hospitalizations, and deaths occur in older adults. Higher morbidity and mortality rates among older versus younger individuals with TBI may contribute to an assumption of futility about aggressive management of geriatric TBI. However, many older adults with TBI respond well to aggressive management and rehabilitation, suggesting that chronological age and TBI severity alone are inadequate prognostic markers. Yet there are few geriatric-specific TBI guidelines to assist with complex management decisions, and TBI prognostic models do not perform optimally in this population. Major barriers in management of geriatric TBI include under-representation of older adults in TBI research, lack of systematic measurement of pre-injury health that may be a better predictor of outcome and response to treatment than age and TBI severity alone, and lack of geriatric-specific TBI common data elements (CDEs). This review highlights the urgent need to develop more age-inclusive TBI research protocols, geriatric TBI CDEs, geriatric TBI prognostic models, and evidence-based geriatric TBI consensus management guidelines aimed at improving short- and long-term outcomes for the large and growing geriatric TBI population.
Collapse
Affiliation(s)
- Raquel C. Gardner
- Department of Neurology, University of California San Francisco, and San Francisco VA Medical Center, San Francisco, California
- University of California San Francisco Weill Institute for Neurosciences, San Francisco, California
| | - Kristen Dams-O'Connor
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Molly Rose Morrissey
- Department of Neurosurgery, Brain and Spinal Injury Center, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California
| | - Geoffrey T. Manley
- University of California San Francisco Weill Institute for Neurosciences, San Francisco, California
- Department of Neurosurgery, Brain and Spinal Injury Center, University of California San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California
| |
Collapse
|
23
|
Sran R, Djerboua M, Romanow N, Mitra T, Russell K, White K, Goulet C, Emery C, Hagel B. Ski and snowboard school programs: Injury surveillance and risk factors for grade-specific injury. Scand J Med Sci Sports 2017; 28:1569-1577. [PMID: 29265554 DOI: 10.1111/sms.13040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 01/02/2023]
Abstract
The objective of our study was to evaluate incidence rates and profile of school program ski and snowboard-related injuries by school grade group using a historical cohort design. Injuries were identified via Accident Report Forms completed by ski patrollers. Severe injury was defined as those with ambulance evacuation or recommending patient transport to hospital. Poisson regression analysis was used to examine the school grade group-specific injury rates adjusting for risk factors (sex, activity, ability, and socioeconomic status) and accounting for the effect of clustering by school. Forty of 107 (37%) injuries reported were severe. Adolescents (grades 7-12) had higher crude injury rates (91 of 10 000 student-days) than children (grades 1-3: 25 of 10 000 student-days; grades 4-6: 65 of 10 000 student-days). Those in grades 1-3 had no severe injuries. Although the rate of injury was lower in grades 1-3, there were no statistically significant grade group differences in adjusted analyses. Snowboarders had a higher rate of injury compared with skiers, while higher ability level was protective. Participants in grades 1-3 had the lowest crude and adjusted injury rates. Students in grades 7-12 had the highest rate of overall and severe injuries. These results will inform evidence-based guidelines for school ski/snowboard program participation by school-aged children.
Collapse
Affiliation(s)
- R Sran
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - M Djerboua
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada
| | - N Romanow
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada
| | - T Mitra
- Sports Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
| | - K Russell
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - K White
- WinSport, Calgary, AB, Canada
| | - C Goulet
- Department of Physical Education, Laval University, Québec City, QC, Canada
| | - C Emery
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada.,Sports Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.,O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
| | - B Hagel
- Department of Paediatrics, University of Calgary, Calgary, AB, Canada.,Sports Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.,O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
24
|
Summers Z, Teague WJ, Hutson JM, Palmer CS, Jowett HE, King SK. The spectrum of pediatric injuries sustained in snow sports. J Pediatr Surg 2017; 52:2038-2041. [PMID: 28958714 DOI: 10.1016/j.jpedsurg.2017.08.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 08/28/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Snow sports are popular among children but carry the potential for significant injury. Head injuries are less common than fractures and sprains but may be fatal. Helmets are recommended for all snow sports, and yet their effectiveness remains unknown. We aimed to evaluate the spectrum of injuries sustained at three large alpine resorts and to assess the effect of helmet usage on injury severity. METHODS We performed a retrospective analysis of prospectively collected pediatric trauma data (2005-2015) from the three largest alpine resorts in our state. Data were analyzed using Spearman's correlation, chi-square, and odds ratio. RESULTS A total of 6299 incidents were reviewed. Skiers accounted for 3821 (60.7%) patients, while snowboarders accounted for 2422 (38.5%) patients. More than half (53.5%) of the injuries were related to falls, predominantly affecting knees in skiers and wrists in snowboarders. Overall, helmet usage decreased with age (p<0.001), though helmet uptake was positively associated with higher level of ability in both skiers and snowboarders (p<0.001). Concussions in both skiers and snowboarders were inversely correlated with the rates of helmet usage (p<0.05). CONCLUSION Helmet usage was associated with reduced rates of concussion. However, helmet usage decreased with age. We advocate for promotion of helmet usage, using mandatory guidelines, across all pediatric age groups. LEVEL OF EVIDENCE Level II - Retrospective study.
Collapse
Affiliation(s)
- Zara Summers
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia; F. Douglas Stephens Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Warwick J Teague
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia; F. Douglas Stephens Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Trauma Service, The Royal Children's Hospital, Melbourne, Australia
| | - John M Hutson
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia; F. Douglas Stephens Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Urology, The Royal Children's Hospital, Melbourne, Australia
| | - Cameron S Palmer
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Helen E Jowett
- Trauma Service, The Royal Children's Hospital, Melbourne, Australia
| | - Sebastian K King
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia; F. Douglas Stephens Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Gastroenterology and Clinical Nutrition, The Royal Children's Hospital, Melbourne, Australia.
| |
Collapse
|
25
|
Severe injuries associated with skiing and snowboarding: A national trauma data bank study. J Trauma Acute Care Surg 2017; 82:781-786. [PMID: 28030491 DOI: 10.1097/ta.0000000000001358] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Injuries after skiing and snowboarding accidents lead to an estimated 7,000 hospital admissions annually and present a significant burden to the health care system. The epidemiology, injury patterns, hospital resource utilization, and outcomes associated with these severe injuries need further characterization. METHODS The National Trauma Data Bank was queried for the period 2007 to 2014 for admissions with Injury Severity Score > 15 and International Classification of Diseases Codes-9th Revision codes 885.3 (fall from skis, n = 1,353) and 885.4 (fall from snowboard, n = 1,216). Demographics, emergency department data, diagnosis and procedure codes, and outcomes were abstracted from the database. RESULTS Severe (Injury Severity Score > 15) ski-associated and snowboard-associated injuries differed with respect to age distribution (median age, 38; interquartile range, 19-59 for skiers and median age, 20; interquartile range, 16-25 for snowboarders; p < 0.001) and sex (78.9% and 86.4% males, respectively, p < 0.001). Traumatic brain injury was common for both sports (56.8% of skiers vs. 46.6% of snowboarders, p < 0.001). Injuries to the spine (28.9%), chest (37.6%), and abdomen (35.0%) were also common. Eighty percent of patients used emergency medical services (50% ambulance, 30% helicopter) with a median emergency medical services transport time of 84 minutes. 50.8% of patients required interhospital transport. 43.2% of injuries required surgical intervention (21.3% orthopedic, 12.5% neurosurgical, 10.5% thoracic, 7.8% abdominal). Median hospital length of stay was 5.0 days. 60.0% of patients required intensive care unit admission with median intensive care unit length of stay 3.0 days. Overall mortality was 4.0% for skiers and 1.9% for snowboarders. CONCLUSION Severe injuries after ski and snowboard accidents are associated with significant morbidity and mortality. Differences in injury patterns, risk factors for severe injury, and resource utilization require further study. Increased resource allocation to alpine trauma systems is warranted. LEVEL OF EVIDENCE Prognostic/epidemiologic, level III.
Collapse
|
26
|
DeFroda SF, Gil JA, Owens BD. Epidemiology of lower extremity injuries presenting to the emergency room in the United States: Snow skiing vs. snowboarding. Injury 2016; 47:2283-2287. [PMID: 27424530 DOI: 10.1016/j.injury.2016.07.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 07/03/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To quantify and compare the incidence of lower extremity injuries in skiers and snowboarders who present to emergency rooms in the United States. METHODS Cross-sectional study of lower extremity injuries in skiers and snowboarders that were evaluated in emergency rooms in the United States. The National Electric Injury Surveillance System (NEISS) database was queried from January 1st, 2014 and December 31st, 2014 and the reported cases of lower extremity injuries in skiers and snowboarders were examined. RESULTS An estimated total of 13,381 snow skiing and 6061 snowboarding lower extremity injuries presented to the emergency department in 2014 representing a national incidence of 42 injuries per 1,000,000 person-years for skiers and 19 injuries for snowboarders. The most common region of the lower extremity that was injured was the knee for skiers (47%) and the lower trunk (e.g. pelvis, hip, lumbar spine) for snowboarders (34%). The incidence of injuries in the pediatric and young adult population in skiers (62 per 1,000,000 person-years) and snowboarders (40 per 1,000,000 person-years) was significantly higher than the incidence of these injuries in adult population (35 and 12 per 1,000,000 person-years respectively) (P<0.01). The incidence of these injuries was significantly higher in males compared to females in both skiing (46 per 1,000,000 person-years vs. 38 per 1,000,000 person-years, P<0.01) and snowboarding (30 per 1,000,000 person-years vs. 9 per 1,000,000 person-years, P <0.01). The rate of injuries from 2010 to 2014 for skiers remained stable while snowboarding injuries down trended approaching significance. CONCLUSION The incidence of lower extremity injuries in skiers was higher than that of snowboarders in 2014, with the 0-19year old age group and males being those most likely to sustain an injury. The most common region of the lower extremity that was injured was the knee for skiers and the lower trunk (e.g. pelvis, hip, lumbar spine) for snowboarders. Physicians and consumers alike should be aware of this data when considering participation in these sports as well as strategies for injury prevention.
Collapse
Affiliation(s)
- Steven F DeFroda
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI 02903.
| | - Joseph A Gil
- Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI 02903.
| | - Brett D Owens
- Department of Orthopaedic Surgery, Professor of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI 02903.
| |
Collapse
|
27
|
Characteristics and Risk Factors of Spinal Fractures in Recreational Snowboarders Attending an Emergency Department in Japan. Clin J Sport Med 2016; 26:405-10. [PMID: 26540597 DOI: 10.1097/jsm.0000000000000267] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to elucidate the characteristics of spinal fractures during recreational snowboarding and to determine the risk factors for these fractures. DESIGN Case series study. SETTING The Oku-mino ski area during the 7-year period between the 2005 to 2006 and 2011 to 2012 skiing seasons. PARTICIPANTS Eight thousand seven hundred twenty-three snowboarders with injures. INTERVENTIONS Cases involved snowboarders with spinal fractures; controls were snowboarders without spinal fractures. MAIN OUTCOME MEASURES The characteristics of spinal fractures were assessed using a standard form and patient records, including radiographs. Multivariate regression analysis was performed to investigate risk factors for spinal fractures, including age, type of slope, snow condition, accident cause, self-reported skill level, experience level, and the use of protective equipment. RESULTS Of 8723 snowboarders with injuries, 431 snowboarders presented with spinal fractures (4.9%). The most common spinal fracture was isolated transverse process fracture in the lumbar spine (33.2%, n = 143), followed by compression type fracture in the lumbar spine (25.1%, n = 108). Age (20-39 years), terrain slopes (half-pipe/box/kicker/rail), and jump-landing failure were associated with a significantly high risk of spinal fracture. CONCLUSIONS Among the recreational snowboarders, isolated transverse process fracture in the lumbar spine was the most frequent spinal fracture. Age (20-39 year old), terrain slopes, and jump-landing failure were found to be risk factors for spinal fracture. CLINICAL RELEVANCE Identification of characteristics and risk factors for spinal fractures during snowboarding is useful information to create a preventive strategy for the fractures and make snowboarding a safer sport.
Collapse
|
28
|
Klick C, Jones CM, Adler D. Surfing USA: an epidemiological study of surfing injuries presenting to US EDs 2002 to 2013. Am J Emerg Med 2016; 34:1491-6. [DOI: 10.1016/j.ajem.2016.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/29/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022] Open
|
29
|
Nathanson BH, Ribeiro K, Henneman PL. An Analysis of US Emergency Department Visits From Falls From Skiing, Snowboarding, Skateboarding, Roller-Skating, and Using Nonmotorized Scooters. Clin Pediatr (Phila) 2016; 55:738-44. [PMID: 26324666 DOI: 10.1177/0009922815603676] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We analyzed the US incidence of emergency department (ED) visits and hospitalizations for falls from skiing, snowboarding, skateboarding, roller-skating, and nonmotorized scooters in 2011. The outcome was hospital admission from the ED. The primary analysis compared pediatric patients aged 1 to 17 years to adults aged 18 to 44 years. The analysis used ICD-9 E-codes E885.0 to E885.4 using discharge data from the Nationwide Emergency Department Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. Approximately 214 000 ED visits met study criteria. Skiing injuries had the highest percentage of hospitalizations (3.30% in pediatric patients and 6.65% in adults 18-44 years old). Skateboard and snowboard injuries were more likely to require hospitalization than roller skating injuries in pediatric patients (odds ratio = 2.42; 95% CI = 2.14-2.75 and odds ratio = 1.83; 95% CI =1.55-2.15, respectively). In contrast, skateboard and snowboard injuries were less severe than roller-skating injuries in adults.
Collapse
Affiliation(s)
| | | | - Philip L Henneman
- Baystate Medical Center, Springfield, MA, USA Tufts University School of Medicine, Boston, MA, USA
| |
Collapse
|
30
|
Bailly N, Llari M, Donnadieu T, Masson C, Arnoux PJ. Head impact in a snowboarding accident. Scand J Med Sci Sports 2016; 27:964-974. [DOI: 10.1111/sms.12699] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- N. Bailly
- Laboratoire de Biomécanique Appliquée; UMRT24 IFSTTAR - Université de la Méditerranée; Marseille Cedex 20 France
- Salomon S.A.S.; Annecy Cedex 9 France
| | - M. Llari
- Laboratoire de Biomécanique Appliquée; UMRT24 IFSTTAR - Université de la Méditerranée; Marseille Cedex 20 France
| | | | - C. Masson
- Laboratoire de Biomécanique Appliquée; UMRT24 IFSTTAR - Université de la Méditerranée; Marseille Cedex 20 France
| | - P. J. Arnoux
- Laboratoire de Biomécanique Appliquée; UMRT24 IFSTTAR - Université de la Méditerranée; Marseille Cedex 20 France
| |
Collapse
|
31
|
Three-dimensional lower extremity joint loading in a carved ski and snowboard turn: a pilot study. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2014; 2014:340272. [PMID: 25317202 PMCID: PMC4181787 DOI: 10.1155/2014/340272] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 07/30/2014] [Indexed: 11/25/2022]
Abstract
A large number of injuries to the lower extremity occur in skiing and snowboarding. Due to the difficulty of collecting 3D kinematic and kinetic data with high accuracy, a possible relationship between injury statistic and joint loading has not been studied. Therefore, the purpose of the current study was to compare ankle and knee joint loading at the steering leg between carved ski and snowboard turns. Kinetic data were collected using mobile force plates mounted under the toe and heel part of the binding on skies or snowboard (KISTLER). Kinematic data were collected with five synchronized, panning, tilting, and zooming cameras. An extended version of the Yeadon model was applied to calculate inertial properties of the segments. Ankle and knee joint forces and moments were calculated using inverse dynamic analysis. Results showed higher forces along the longitudinal axis in skiing and similar forces for skiing and snowboarding in anterior-posterior and mediolateral direction. Joint moments were consistently greater during a snowboard turn, but more fluctuations were observed in skiing. Hence, when comparing joint loading between carved ski and snowboard turns, one should differentiate between forces and moments, including the direction of forces and moments and the turn phase.
Collapse
|
32
|
Stenroos A, Handolin L. Incidence of Recreational Alpine Skiing and Snowboarding Injuries: Six Years Experience in the Largest Ski Resort in Finland. Scand J Surg 2014; 104:127-31. [PMID: 24786173 DOI: 10.1177/1457496914532249] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 03/09/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS The aim of this study was to provide information on incidences and severity of recreational alpine skiing and snowboarding injuries in Northern Finland and to discuss possible preventive measures to reduce the number and severity of injuries in the future. MATERIALS AND METHODS This retrospective study consists of all injured skiers and snowboarders in the Levi Ski Resort during the 2006-2012 winter seasons. The Levi Ski Resort has a SKIDATA® system which records automatically every ski-lift run taking place. The emergency system of the resort registers the data (conditions during the injury, patient characteristics, and observed and/or suspected injuries) of all injured persons they meet. The severity of injury is defined by the needed level of care: Grade 1 (treated by the emergency system with no need for further referral), Grade 2 (referral to the local primacy care clinic), Grade 3 (transfer to hospital by ambulance), and Grade 4 (transfer to tertiary care by helicopter). RESULTS During the 6-year study period, there were 29,576.132 lift runs and 2911 injuries were met by the emergency system, resulting in the average injury incidence of 0.98 injuries per 10,000 lift runs. Vice versa, the average number of the ski-lift rides needed to generate one injury was 10,160. The knee injuries of the skiers constituted almost one-third of all cases, whereas snowboarders sustained more injuries to the upper limb and axial areas. CONCLUSION Skiing and snowboarding are related to a relatively high risk of injury. The most common injuries affect the knee in skiers and the upper extremity, especially the wrist, in snowboarders. A continuous and systematic review of injuries is needed to monitor the effects of changes made in terms of the safety.
Collapse
Affiliation(s)
- A Stenroos
- Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - L Handolin
- Department of Orthopedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
33
|
Wijdicks CA, Rosenbach BS, Flanagan TR, Bower GE, Newman KE, Clanton TO, Engebretsen L, LaPrade RF, Hackett TR. Injuries in elite and recreational snowboarders. Br J Sports Med 2013; 48:11-7. [DOI: 10.1136/bjsports-2013-093019] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
34
|
Davis CB, Brownson MR, Levy BJ, Valley MA, Evans B, Lowenstein SR. Employee perception of a mandated helmet policy at Vail Resorts. Wilderness Environ Med 2013; 24:402-6. [PMID: 24001389 DOI: 10.1016/j.wem.2013.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 06/05/2013] [Accepted: 06/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The purpose of this study was to measure support for a mandated helmet policy among resort employees along with the impact of such a policy on job satisfaction, and additionally, to measure the prevalence of barriers to helmet use among this population. METHODS In all, 728 Vail Resort employees were surveyed regarding their opinions on the helmet policy and on general helmet use. RESULTS The majority of the 728 employees surveyed (66.5%; 95% CI: 63% to 70%) agreed with the helmet policy. Only 18% (95% CI: 16% to 21%) reported a negative effect on job satisfaction. Older employees (>25 years old) were more likely to disagree with the policy (odds ratio [OR] 3.1; 95% CI: 2.2 to 4.3) and report a negative effect on job satisfaction (OR 4.8; 95% CI: 3.0 to 7.6). Skiers were much more likely than snowboarders to report a negative effect on job satisfaction (OR 9.8; 95% CI: 5.2 to 18.1). Among resort employees, ski patrollers were more likely to disagree with the mandate (OR 9.8; 95% CI: 6.8 to 13.9) and report a negative effect on job satisfaction (OR 13.2; 95% CI: 8.3 to 21.). Forty-three percent of participants (95% CI: 39% to 46%) agreed with the statement that wearing a helmet encourages reckless behavior whereas 51.0% (95% CI: 47% to 54%) believed that wearing a helmet limits sensory perception. CONCLUSIONS A mandatory helmet use policy was supported by most resort employees. However, ski patrollers and older, more experienced employees were more likely to report a negative effect on job satisfaction. Barriers to helmet use continue to persist in the ski industry and represent a target for further educational efforts.
Collapse
Affiliation(s)
- Christopher B Davis
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.
| | | | | | | | | | | |
Collapse
|
35
|
Stathokostas L, Theou O, Little RMD, Vandervoort AA, Raina P. Physical Activity-Related Injuries in Older Adults: A Scoping Review. Sports Med 2013; 43:955-63. [DOI: 10.1007/s40279-013-0076-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
36
|
Graves JM, Whitehill JM, Stream JO, Vavilala MS, Rivara FP. Emergency department reported head injuries from skiing and snowboarding among children and adolescents, 1996-2010. Inj Prev 2013; 19:399-404. [PMID: 23513009 DOI: 10.1136/injuryprev-2012-040727] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the incidence of snow-sports-related head injuries among children and adolescents reported to emergency departments (EDs), and to examine the trend from 1996 to 2010 in ED visits for snow-sports-related traumatic brain injury (TBI) among children and adolescents. METHODS A retrospective, population-based cohort study was conducted using data from the National Electronic Injury Surveillance System for patients (aged ≤17 years) treated in EDs in the USA from 1996 to 2010, for TBIs associated with snow sports (defined as skiing or snowboarding). National estimates of snow sports participation were obtained from the National Ski Area Association and utilised to calculate incidence rates. Analyses were conducted separately for children (aged 4-12 years) and adolescents (aged 13-17 years). RESULTS An estimated number of 78 538 (95% CI 66 350 to 90 727) snow sports-related head injuries among children and adolescents were treated in EDs during the 14-year study period. Among these, 77.2% were TBIs (intracranial injury, concussion or fracture). The annual average incidence rate of TBI was 2.24 per 10 000 resort visits for children compared with 3.13 per 10 000 visits for adolescents. The incidence of TBI increased from 1996 to 2010 among adolescents (p<0.003). CONCLUSIONS Given the increasing incidence of TBI among adolescents and the increased recognition of the importance of concussions, greater awareness efforts may be needed to ensure safety, especially helmet use, as youth engage in snow sports.
Collapse
Affiliation(s)
- Janessa M Graves
- Harborview Injury Prevention and Research Center (HIPRC), University of Washington, , Seattle, Washington, USA
| | | | | | | | | |
Collapse
|
37
|
Wang D, Zhao W, Wheeler K, Yang G, Xiang H. Unintentional fall injuries among US children: a study based on the National Emergency Department Sample. Int J Inj Contr Saf Promot 2013; 20:27-35. [DOI: 10.1080/17457300.2012.656316] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
38
|
Abstract
Skiing and snowboarding are popular recreational and competitive sport activities for children and youth. Injuries associated with both activities are frequent and can be serious. There is new evidence documenting the benefit of wearing helmets while skiing and snowboarding, as well as data refuting suggestions that helmet use may increase the risk of neck injury. There is also evidence to support using wrist guards while snowboarding. There is poor uptake of effective preventive measures such as protective equipment use and related policy. Physicians should have the information required to counsel children, youth and families regarding safer snow sport participation, including helmet use, wearing wrist guards for snowboarding, training and supervision, the importance of proper equipment fitting and binding adjustment, sun safety and avoiding substance use while on the slopes.
Collapse
|
39
|
Pappas E, Zazulak BT, Yard EE, Hewett TE. The Epidemiology of Pediatric Basketball Injuries Presenting to US Emergency Departments: 2000-2006. Sports Health 2012; 3:331-5. [PMID: 23016025 PMCID: PMC3445204 DOI: 10.1177/1941738111409861] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: There is limited published research on the epidemiology of basketball injuries treated in US emergency departments (EDs). Hypothesis: Age and sex patterns exist for the most common pediatric basketball injuries treated in EDs. Study Design: Descriptive epidemiology study. Methods: Data from the National Electronic Injury Surveillance System and the National Sporting Goods Association were used to calculate national injury incidence rates and 95% confidence intervals of pediatric basketball injuries. Results: An estimated 325 465 annual visits were made to US EDs for pediatric basketball-related injuries from 2000 to 2006. The 5 most common injuries were ankle sprains (21.7%), finger sprains (8.0%), finger fractures (7.8%), knee sprains (3.9%), and facial lacerations (3.9%). Among persons aged 12 to 17 years, girls had a higher rate of knee sprains than boys (P < 0.001), but this association did not exist among those aged 7 to 11 years (P = 0.27). Boys had a higher rate of facial lacerations than girls (P < 0.01). Among persons aged 12 to 17 years, girls had a higher rate of finger sprains (P < 0.01). For both boys and girls, the rate of the 5 most common basketball injuries was higher among those aged 12 to 17 years compared with those aged 7 to 11 years (P < 0.01). Conclusions: The annual number of basketball-related pediatric ED visits approaches a third of a million and demonstrates the extent of the public health problem that injuries in this sport pose. Distinct sex and age patterns were observed. Clinical Relevance: The study findings provide important information on basketball injury rates that may be used for targeting prevention interventions by sex and age group.
Collapse
Affiliation(s)
- Evangelos Pappas
- Division of Physical Therapy, Long Island University, Brooklyn, New York
| | | | | | | |
Collapse
|
40
|
Improving prehospital trauma management for skiers and snowboarders - need for on-slope triage? J Trauma Manag Outcomes 2011; 5:5. [PMID: 21521524 PMCID: PMC3098779 DOI: 10.1186/1752-2897-5-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Accepted: 04/26/2011] [Indexed: 11/27/2022]
Abstract
Background Injuries from skiing and snowboarding became a major challenge for emergency care providers in Switzerland. In the alpine setting, early assessment of injury and health status is essential for the initiation of adequate means of care and transport. Nevertheless, validated standardized protocols for on-slope triage are missing. This article can assist in understanding the characteristics of injured winter sportsmen and exigencies for future on-slope triage protocols. Methods Six-year review of trauma cases in a tertiary trauma centre. Consecutive inclusion of all injured skiers and snowboarders aged >15 (total sample) years with predefined, severe injury to the head, spine, chest, pelvis or abdomen (study sample) presenting at or being transferred to the study hospital. Descriptive analysis of age, gender and injury pattern. Results Amongst 729 subjects (total sample) injured from skiing or snowboarding, 401 (55%, 54% of skiers and 58% of snowboarders) suffered from isolated limb injury. Amongst the remaining 328 subjects (study sample), the majority (78%) presented with monotrauma. In the study sample, injury to the head (52%) and spine (43%) was more frequent than injury to the chest (21%), pelvis (8%), and abdomen (5%). The three most frequent injury combinations were head/spine (10% of study sample), head/thorax (9%), and spine/thorax (6%). Fisher's exact test demonstrated an association for injury combinations of head/thorax (p < 0.001), head/abdomen (p = 0.019), and thorax/abdomen (p < 0.001). Conclusion The data presented and the findings from previous investigations indicate the need for development of dedicated on-slope triage protocols. Future research must address the validity and practicality of diagnostic on-slope tests for rapid decision making by both professional and lay first responders. Thus, large-scale and detailed injury surveillance is the future research priority.
Collapse
|
41
|
|
42
|
Girardi P, Braggion M, Sacco G, De Giorgi F, Corra S. Factors affecting injury severity among recreational skiers and snowboarders: an epidemiology study. Knee Surg Sports Traumatol Arthrosc 2010; 18:1804-9. [PMID: 20390247 DOI: 10.1007/s00167-010-1133-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Different results have been reported for skiing and snowboarding injuries worldwide. Few studies consider the injury severity score (ISS) for the evaluation of differences among injured skiers-snowboarders. The aim of this study is to identify possible risk factors that affect the severity of skiing and snowboarding injuries in three winter seasons (2002-2005) in South Tyrol. For every injured skier or snowboarder referred to our emergency department in three consecutive seasons, the following data were collected: date of birth, gender, self-declared technical skills level, place of residence (local/non-local), as well as the date, time, and place of the accident. Type of injury and ISS were retrospectively assigned. Data concerning the snowfall in the last 24 h, average snow level, and outdoor air temperature values were obtained from four weather stations that were located inside the ski resorts. A multiple linear regression model was used to evaluate the association between ISS and potential determinants. In the analyzed seasons, 2,511 injured skiers and 843 injured snowboarders were evaluated at our emergency department. There was a significant change in the ISS value for subjects with different self-reported skills levels (P < 0.001). Men and non-local residents experienced more severe injuries than women and local residents, respectively (P < 0.013, P < 0.001). The ISS was higher for people aged over 60 (P < 0.001). Snowfalls brought about a decrease in accident severity (P = 0.009). The severity of the injuries increases with age. Prevention and information programs should be targeted to people who are at high risk of severe injury. A 24-h fresh snowfall seems to reduce the severity of injuries. Very little is known about snow conditions and winter sports injury. Further studies are needed to explore this field.
Collapse
Affiliation(s)
- Paolo Girardi
- Unit of Epidemiology and Medical Statistics, Department of Medicine and Public Health, University of Verona, Verona, Italy
| | | | | | | | | |
Collapse
|
43
|
Frosch KH, Stengel D, Brodhun T, Stietencron I, Holsten D, Jung C, Reister D, Voigt C, Niemeyer P, Maier M, Hertel P, Jagodzinski M, Lill H. Outcomes and risks of operative treatment of rupture of the anterior cruciate ligament in children and adolescents. Arthroscopy 2010; 26:1539-50. [PMID: 21035009 DOI: 10.1016/j.arthro.2010.04.077] [Citation(s) in RCA: 144] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 04/18/2010] [Accepted: 04/22/2010] [Indexed: 02/02/2023]
Abstract
PURPOSE The aim of this meta-analysis was to evaluate the clinical outcomes and risks of anterior cruciate ligament (ACL) surgery in children and adolescents. METHODS We electronically searched Medline, the Cochrane Controlled Trial Database, Embase, and Medpilot for studies on surgical treatment for ACL ruptures in skeletally immature patients. We extracted baseline demographics, follow-up intervals, surgical details (i.e., ligament suture or reconstruction, physeal-sparing or transphyseal techniques, type of transplant, and methods of fixation). Endpoints comprised rates of growth disturbances and reruptures, as well as knee function (measured by the International Knee Documentation Committee's documentation system and the Lysholm score). Unweighted overall effect sizes (risks, risk ratios [RRs], and means of functional scores) were estimated by use of crude nominators and denominators, and random-effects meta-regression analysis was used for weighted data synthesis. RESULTS A total of 55 articles reporting on 935 patients (median age, 13 years; range, 1.5 to 16 years) were suitable for the study. After a median follow-up of 40 months (range, 14 to 89 months), the weighted rate of leg-length differences or axis deviations was 1.8% (95% confidence interval [CI], 0% to 3.9%] and that of reruptures was 4.8% (95% CI, 2.9% to 6.7%). Excellent or good function (International Knee Documentation Committee grade A or B) was achieved in 84.2% (95% CI, 75.8% to 92.6%) of all knees, and Lysholm scores averaged 96.3 (95% CI, 95.5 to 97.2). Transphyseal reconstruction was associated with a significantly lower risk of leg-length differences or axis deviations compared with physeal-sparing techniques (1.9% v 5.8%; RR, 0.34; 95% CI, 0.14 to 0.81) but had a higher risk of rerupture (4.2% v 1.4%; RR, 2.91; 95% CI, 0.70 to 12.12). Sutures did not result in any growth disturbances, with a weighted rerupture rate of 4.6% (95% CI, 2.6 to 6.7). Fixation far from the joint line fared better than close fixation with regard to this endpoint (1.4% v 3.2%; RR, 0.42; 95% CI, 0.09 to 1.93). Bone-patellar tendon-bone grafts, which are also less likely to fail, were associated with higher risks of leg-length differences or axis deviations than were hamstrings (3.6% v 2.0%; RR, 1.82; 95% CI, 0.66 to 5.03). Meta-regression did not show a significant impact of the publication year on event rates. CONCLUSIONS This meta-analysis showed low rates of leg-length differences or axis deviations and graft failures after ACL reconstruction in skeletally immature patients. Hamstring transplants may lower the risk of leg-length differences or axis deviations, and physeal-sparing techniques may increase the risk. Randomized controlled trials are needed to clarify important issues in managing ACL ruptures in children and adolescents. LEVEL OF EVIDENCE Level IV, meta-analysis of case series.
Collapse
Affiliation(s)
- Karl-Heinz Frosch
- Department of Trauma Surgery, Plastic and Reconstructive Surgery, Georg-August-University, Göttingen, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Brooks MA, Evans MD, Rivara FP. Evaluation of skiing and snowboarding injuries sustained in terrain parks versus traditional slopes. Inj Prev 2010; 16:119-22. [PMID: 20363819 DOI: 10.1136/ip.2009.022608] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This study compares skiing and snowboarding injuries in terrain parks versus slopes at two ski areas, 2000-05. A total of 3953 (26.7%) injuries occurred in terrain parks, predominantly among young male snowboarders. Terrain park injuries were more likely to be severe, involving head (RR 1.31, 95% CI 1.16 to 1.48) or back (RR 1.96, 95% CI 1.67 to 2.29).
Collapse
Affiliation(s)
- M Alison Brooks
- Department of Orthopaedics and Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin, USA.
| | | | | |
Collapse
|
45
|
Leon-Carrion J, Dominguez-Roldan JM, Leon-Dominguez U, Murillo-Cabezas F. The Infrascanner, a handheld device for screeningin situfor the presence of brain haematomas. Brain Inj 2010; 24:1193-201. [DOI: 10.3109/02699052.2010.506636] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
46
|
Russell K, Christie J, Hagel BE. The effect of helmets on the risk of head and neck injuries among skiers and snowboarders: a meta-analysis. CMAJ 2010; 182:333-40. [PMID: 20123800 PMCID: PMC2831705 DOI: 10.1503/cmaj.091080] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The prevention of head injuries in alpine activities has focused on helmets. However, no systematic review has examined the effect of helmets on head and neck injuries among skiers and snowboarders. METHODS We searched electronic databases, conference proceedings and reference lists using a combination of the key words "head injury or head trauma," "helmet" and "skiing or snowboarding." We included studies that used a control group; compared skiers or snowboarders with and without helmets; and measured at least one objectively quantified outcome (e.g., head injury, and neck or cervical injury). RESULTS We included 10 case-control, 1 case-control/case-crossover and 1 cohort study in our analysis. The pooled odds ratio (OR) indicated that skiers and snowboarders with a helmet were significantly less likely than those without a helmet to have a head injury (OR 0.65, 95% confidence interval [CI] 0.55-0.79). The result was similar for studies that used controls without an injury (OR 0.61, 95% CI 0.36-0.92), those that used controls with an injury other than a head or neck injury (OR 0.63, 95% CI 0.52-0.80) and studies that included children under the age of 13 years (OR 0.41, 95% CI 0.27-0.59). Helmets were not associated with an increased risk of neck injury (OR 0.89, 95% CI 0.72-1.09). INTERPRETATION Our findings show that helmets reduce the risk of head injury among skiers and snowboarders with no evidence of an increased risk of neck injury.
Collapse
Affiliation(s)
- Kelly Russell
- From the Department of Community Health Sciences, Faculty of Medicine (Russell); the Bachelor of Health Sciences Program, Faculty of Medicine (Christie); and the Departments of Paediatrics and Community Health Sciences, Faculty of Medicine (Hagel), University of Calgary, Calgary, Alta
| | - Josh Christie
- From the Department of Community Health Sciences, Faculty of Medicine (Russell); the Bachelor of Health Sciences Program, Faculty of Medicine (Christie); and the Departments of Paediatrics and Community Health Sciences, Faculty of Medicine (Hagel), University of Calgary, Calgary, Alta
| | - Brent E. Hagel
- From the Department of Community Health Sciences, Faculty of Medicine (Russell); the Bachelor of Health Sciences Program, Faculty of Medicine (Christie); and the Departments of Paediatrics and Community Health Sciences, Faculty of Medicine (Hagel), University of Calgary, Calgary, Alta
| |
Collapse
|
47
|
|
48
|
Lawson BR, Comstock RD, Smith GA. Baseball-related injuries to children treated in hospital emergency departments in the United States, 1994-2006. Pediatrics 2009; 123:e1028-34. [PMID: 19482735 DOI: 10.1542/peds.2007-3796] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the epidemiology of baseball-related injuries among children in the United States. METHODS This was a retrospective analysis of data for children younger than 18 years of age from the National Electronic Injury Surveillance System (NEISS) of the Consumer Product Safety Commission from 1994 through 2006. Sample weights provided by the NEISS were used to calculate national estimates of baseball-related injuries. Injury rates were calculated according to age group by using both population and baseball-participation data. RESULTS An estimated 1 596 000 (95% confidence interval: 1 330 100-1 861 800) children younger than 18 years were treated in US hospital emergency departments for baseball-related injuries during the 13-year period from 1994 through 2006. During the study period, the annual number of injuries declined by 24.9%, and the annual injury rate for children younger than 18 years decreased significantly (P < .000). The most commonly injured body parts were the face (33.5%) and the upper extremity (32.4%). The most common injury diagnoses were soft tissue injury (34.3%) and fracture (18.4%). The most common mechanism of injury was being hit by the baseball (46.0%). Children in the 9- to 12-year age group had the highest injury rate (2.4 per 1000 population). When injury rates were calculated by using baseball-participation data (2003), children in the 12- to 17-year age group had a higher injury rate (19.8 per 1000 participants) than those in the 6- to 11-year age group (12.1 per 1000 participants). CONCLUSIONS Youth baseball is a relatively safe sport for children. Although injury rates and the total number of injuries declined during the study period, our findings indicate that there are opportunities for making baseball an even safer sport for children. We recommend that all youth baseball players wear properly fitted mouth guards, that all leagues, schools, and parks install safety bases, that all batters use helmets with face shields, and that all players use safety baseballs.
Collapse
Affiliation(s)
- Bradley R Lawson
- Research Institute at Nationwide Children's Hospital, Center for Injury Research and Policy, 700 Children's Dr, Columbus, OH 43205, USA
| | | | | |
Collapse
|
49
|
Toth C. The Epidemiology of Injuries to the Nervous System Resulting from Sport and Recreation. Phys Med Rehabil Clin N Am 2009; 20:1-28, vii. [DOI: 10.1016/j.pmr.2008.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
50
|
The Epidemiology of Injuries to the Nervous System Resulting from Sport and Recreation. Neurol Clin 2008; 26:1-31; vii. [DOI: 10.1016/j.ncl.2007.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|