Snowboarding injuries: general patterns, with a focus on talus fractures

ACR Appropriateness Criteria acute trauma to the ankle

Acute ankle injuries are frequently diagnosed and treated in emergency departments and outpatient clinics. Recent evidence-based clinical treatment guidelines and systematic review of economic analyses support the use of 3-view (anteroposterior, lateral, and mortise) radiographic evaluation of patients meeting the criteria of the Ottawa ankle rules. Cross-sectional imaging has a limited secondary role primarily as a tool for preoperative planning and as a problem-solving technique in patients with persistent symptoms and suspected of having occult fractures. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Trauma risks and prevention strategies for snowboarders

PURPOSE

To provide primary care providers with current information about the risk of injury and trauma prevention measures for snowboarders.

DATA SOURCES

Selected research articles and Internet sources.

CONCLUSIONS

Beginners are at increased risk for snowboarding injuries. Lower extremity injuries have been reduced in recent years by the introduction of the hybrid boot for beginners. Little has been done to reduce the significant impact of head injuries and wrist fractures to snowboarders.

IMPLICATIONS FOR PRACTICE

Snowboarders comprise approximately 25%-37% of the population on ski slopes. Recommending the use of helmets and wrist guard protection to snowboarding patients is a useful trauma prevention measure. The high rate of injury to the beginner and young snowboarder makes a particularly strong argument for these safety recommendations to this patient population.

In-area and backcountry snowboarding: medical and safety aspects

Snowboarding is now a well-established winter sport and a popular mode of mountaineering. In-area and backcountry snowboarding are defined, as well as a new term, glisse, that refers to all types of skis and snowboards. New developments in equipment focus on boot and binding systems. Backcountry travel is highlighted, including ascent with snowshoes, skis, a splitboard, and crampons. Injuries are about 4-6 per 1000 snowboarding days. Upper extremity injuries are most often wrist sprains or fractures. Lower extremity injuries are primarily ankle sprains and are generally less severe than knee injuries in skiers. Fracture to the lateral process of the talus has been called snowboarder's fracture. Backcountry injuries include avalanche suffocation and trauma, deep snow immersion asphyxiation, hypothermia, frostbite, dehydration, fatigue, acute mountain sickness, and sunburn. Specific recommendations for prevention and safety are discussed.