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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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Tucker NJ, Kelley N, Strage KE, Mauffrey C, Parry JA. Pelvic ring injuries after alpine ski and snowboard accidents. Eur J Orthop Surg Traumatol 2022:10.1007/s00590-022-03331-x. [PMID: 35831489 DOI: 10.1007/s00590-022-03331-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/23/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this study was to analyze the patient/injury characteristics and associated hospital course of patients sustaining traumatic pelvic ring injuries after alpine ski and snowboard accidents at a level one trauma center in the Rocky Mountain region. METHODS Patient/injury characteristics were obtained from patients presenting with pelvic ring injuries after alpine ski (n = 55) and snowboard (n = 9) accidents. Characteristics and outcomes analyzed included mechanism of injury, pelvic ring classification (Young-Burgess and Tile), hospital admission, physical therapy (PT) clearance, ambulation, length of stay, inpatient morphine milligram equivalents (MME), and discharges to rehabilitation facility. RESULTS Snowboarders were more often younger, male, tobacco/substance users, and more likely to be injured by a fall from height than skiers. There were no differences in injury classification or hospital course outcomes between alpine sports. Most common injuries included lateral compression type 1 (LC1) injuries (37.5%), isolated pubic ramus fractures (31.3%), and isolated iliac wing fractures (15.6%). LC1 injuries were unstable in 50% of cases and associated with increased admissions (proportional difference: 47.5%, CI: 23.8-64.5%, p = 0.0002), longer time to PT clearance (median difference(MD): 1.0 day, CI: 0-2.0, p = 0.03), longer LOS (MD: 2.0, CI: 0-2.0, p = 0.02), and increased inpatient MMEs (MD: 197.9 MME, CI: 30.0-420.0, p = 0.02), as compared to other pelvic ring injuries. CONCLUSION The majority of pelvic ring injuries from alpine ski and snowboard accidents were LC1 injuries, half of which were unstable, resulting in longer hospital stays, time to PT clearance/ambulation, and opioid use.
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Affiliation(s)
- Nicholas J Tucker
- Department of Orthopedics, Denver Health Medical Center, Denver Health, 777 Bannock St, MC 0188, Denver, CO, 80204, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Naomi Kelley
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Katya E Strage
- Department of Orthopedics, Denver Health Medical Center, Denver Health, 777 Bannock St, MC 0188, Denver, CO, 80204, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Cyril Mauffrey
- Department of Orthopedics, Denver Health Medical Center, Denver Health, 777 Bannock St, MC 0188, Denver, CO, 80204, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Joshua A Parry
- Department of Orthopedics, Denver Health Medical Center, Denver Health, 777 Bannock St, MC 0188, Denver, CO, 80204, USA.
- University of Colorado School of Medicine, Aurora, CO, USA.
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DiGiacomo G, Tsai S, Bottlang M. Impact Performance Comparison of Advanced Snow Sport Helmets with Dedicated Rotation-Damping Systems. Ann Biomed Eng 2021; 49:2805-2813. [PMID: 33528683 PMCID: PMC8510952 DOI: 10.1007/s10439-021-02723-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/04/2021] [Indexed: 01/04/2023]
Abstract
Rotational acceleration of the head is a principal cause of concussion and traumatic brain injury. Several rotation-damping systems for helmets have been introduced to better protect the brain from rotational forces. But these systems have not been evaluated in snow sport helmets. This study investigated two snow sport helmets with different rotation-damping systems, termed MIPS and WaveCel, in comparison to a standard snow sport helmet without a rotation-damping system. Impact performance was evaluated by vertical drops of a helmeted Hybrid III head and neck onto an oblique anvil. Six impact conditions were tested, comprising two impact speeds of 4.8 and 6.2 m/s, and three impact locations. Helmet performance was quantified in terms of the linear and rotational kinematics, and the predicted probability of concussion. Both rotation-damping systems significantly reduced rotational acceleration under all six impact conditions compared to the standard helmet, but their effect on linear acceleration was less consistent. The highest probability of concussion for the standard helmet was 89%, while helmets with MIPS and WaveCel systems exhibited a maximal probability of concussion of 67 and 7%, respectively. In conclusion, rotation-damping systems of advanced snow sport helmets can significantly reduce rotational head acceleration and the associated concussion risk.
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Affiliation(s)
- Gina DiGiacomo
- Biomechanics Laboratory, Legacy Research Institute, Portland, OR, 97232, USA
| | - Stanley Tsai
- Biomechanics Laboratory, Legacy Research Institute, Portland, OR, 97232, USA
| | - Michael Bottlang
- Biomechanics Laboratory, Legacy Research Institute, Portland, OR, 97232, USA.
- Legacy Biomechanics Laboratory, 1225 NE 2nd Ave, Portland, OR, 97215, USA.
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Abstract
Participation in skiing and snowboarding continues to increase. Both sports are associated with unique equipment and movement patterns, placing athletes at risk for several characteristic injuries. Although the axial skeleton and extremities are at risk for injury in both sports, skiing and snowboarding are associated with distinctive injury patterns. This article summarizes the epidemiology, risk factors, and specific injuries associated with skiing and snowboarding to better educate orthopedic surgeons regarding diagnosis and treatment of athletes partaking in these sports.
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Affiliation(s)
- Zachary L Telgheder
- Department of Orthopedic Surgery, SUNY Upstate Medical University, 750 East Adams Street, Suite 4400, Syracuse, NY 13210, USA.
| | - Brian J Kistler
- Department of Orthopedic Surgery, SUNY Upstate Medical University, 750 East Adams Street, Suite 4400, Syracuse, NY 13210, USA
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Maier GS, Bischel O, Kusche H, Jahnke A, Rickert M, Clarius M, von Engelhardt LV, Seeger JB. Different injury patterns after snowboard in children and adolescents. J Orthop 2020; 19:229-232. [PMID: 32071519 DOI: 10.1016/j.jor.2020.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 10/25/2022] Open
Abstract
Background Snowboarding is a very common sport especially among young adults. Common injuries are hand, wrist, shoulder and ankle injuries. Purpose of this study was to analyze different injury pattern in children and young adults comparing with adults. Methods Patients who were admitted for ambulant or stationary treatment as a result of injury practicing snowboard received a questionnaire and were divided into three groups (children, young adults and adults) according to their age. Between october 2002 and may 2007 1929 injured snowboard sportsmen were included in the study. Data such as location, date and time of accident as well as information about the slope were carried out. In addition snowboard skills were classified and patients were questioned whether they wore special protectors. Results 32.5% of injured patients were female (n = 626) and 67.5% male (n = 1303) with a mean age of patients of 21.9 (7-66) years. 13% of all patients were in group I (children), 19.2% in group II (young adults) and 67.8% in group III (adults).Most common injuries with 60% of all accidents were injuries of the hand wrist especially in children beginning with snowboard sports. Injuries on the regular track were most common followed by jumps in the kicker park and rails in the fun-park. 20.6% in group I, 13.6% in group II and 12.8% group III did not wear any protectors. Conclusion Children and adolescents presented different injury patterns than adults. Young participants of up to 14 years of age are endangered especially during the first days of learning this sport. Further development of protectors with regard to biomechanical characteristics is important to achieve an optimal protective effect. Level of evidence 2b.
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Affiliation(s)
- G S Maier
- University Hospital of Orthopaedic Surgery, Pius-Hospital, Carl-von-Ossietzky-University, Oldenburg, Germany
| | - O Bischel
- BG Trauma Centre Ludwigshafen, Ludwigshafen am Rhein, Germany
| | | | - A Jahnke
- Laboratory of Biomechanics, Justus-Liebig-University Giessen, Giessen, Germany
| | - M Rickert
- Department of Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg (UKGM), Giessen, Germany
| | - M Clarius
- Department of Orthopaedic and Trauma Surgery, Vulpius Klinik GmbH, Bad Rappenau, Germany
| | | | - J B Seeger
- Department of Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg (UKGM), Giessen, Germany
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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.
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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
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Van Laarhoven SN, Latten G, de Loos E, van Hemert W, Vles GF. Annual trauma load of the world's largest indoor skiing center. Eur J Trauma Emerg Surg 2016; 43:233-237. [PMID: 26762312 DOI: 10.1007/s00068-016-0631-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 01/04/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE There is limited data on the trauma load caused by indoor skiing centers. Therefore, all patients treated at the accident and emergency department of our level I trauma center who sustained injuries at the world's largest indoor skiing center were analyzed during a 3-year period. METHODS Business intelligence was used to identify all patients who sustained injury at SnowWorld, Landgraaf, The Netherlands, and were seen at the accident and emergency department of the Zuyderland Medical Center from January 1, 2012 till December 31, 2014. Data were collected on patient characteristics, trauma mechanism, transportation, admission, diagnostics, injury and its severity, and treatment. RESULTS Of the 732 patients seen, 305 had a fracture and 80 a dislocation. Most patients were male snowboarders and most injuries were sustained during winter. More than 2000 X-rays and 100 CT scans were required. Seventy-two patients were admitted and immediate surgery was performed in 21 patients. Ten patients had Injury Severity Scores of 10 or higher. Snowboarders differed significantly from skiers on several parameters, e.g., 1 in 4 snowboarders seen had sustained a distal radius fracture compared to 1 in 100 skiers. CONCLUSION Acquiring more insight into the characteristics of this specific patient population could benefit clinical care and help clinicians identify and target preventive strategies. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- S N Van Laarhoven
- Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Henri Dunantstraat 5, 6419 PC, Heerlen, The Netherlands.
| | - G Latten
- Department of Emergency Medicine, Zuyderland Medical Center, Heerlen, The Netherlands
| | - E de Loos
- Department of Trauma Surgery, Zuyderland Medical Center, Heerlen, The Netherlands
| | - W van Hemert
- Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Henri Dunantstraat 5, 6419 PC, Heerlen, The Netherlands
| | - G F Vles
- Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Henri Dunantstraat 5, 6419 PC, Heerlen, The Netherlands
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