Tibial Fractures in Alpine Skiing and Snowboarding in Finland: A Retrospective Study on Fracture Types and Injury Mechanisms in 363 Patients

Abstract

Background and Aim: alpine skiing and snowboarding share the hazards of accidents accounting for tibial fractures. The aim of this study was to evaluate the fracture patterns and mechanisms of injury of tibial fractures taking place in downhill skiing and snowboarding.Materials and methods: all patients with tibial fracture due to alpine skiing or snowboarding accident treated in four trauma centers next to the largest ski resorts in Finland were analyzed between 2006 and 2012. The hospital records were retrospectively reviewed for data collection: equipment used (skis or snowboard), age, gender, and mechanism of injury. Fractures were classified according to ao-classification.Results: There were 342 skiing and 30 snowboarding related tibial fractures in 363 patients. Tibial shaft fracture was the most common fracture among skiers (n = 215, 63%), followed by proximal tibial fractures (n = 92, 27%). snowboarders were most likely to suffer from proximal tibial fracture (13, 43%) or tibial shaft fracture (11, 37%). snowboarders were also more likely than skiers to suffer complex ao type c fractures (23% vs 9%, p < 0.05). adult skiers had both wider variety of fractures and higher prevalence of proximal tibial fractures compared to children (49% vs 16%, p < 0.05). skiers typically got injured due to falling down on the same level (70%) and snowboarders due to loss of control while jumping (46%). Conclusion:The most important finding was the relatively high number of the tibial plateau fractures among adult skiers. The fracture patterns between snowboarding and skiing were different; the most common fracture type in skiers was spiral tibial shaft

Management of injuries in snowboarders: rehabilitation and return to activity

“… 28 Stenroos et al found tibial plateau fractures slightly more likely than tibia-shaft fractures in snowboarders. 43 Snowboarders were also more likely than skiers to suffer complex periarticular fractures. 43 Complex proximal tibia fractures have been associated with high energy and axial pressure with rotational forces, often associated with loss of control while jumping with hard snowboard boots.…”

“…In a retrospective study of 363 skiers and snowboarders suffering tibial fractures over a 7-year period, only 8% of the tibial fractures occurred in snowboarders. 43 Ishimaru et al showed that tibia-shaft fractures accounted for 42% of all lower-leg fractures in their series of snowboarding injuries. 28 Similar to skiers, hard snowboard boots place snowboarders at risk for fractures of the fibula and tibia at the top of the boot, known as a boot-top fracture.…”

Femur Fracture Associated with Knee Brace Wear in the Motocross Athlete: A Report of Two Cases and Review of the Literature

“…The aforementioned boot top fracture findings led to an alteration of ski boots' safety bindings, and the ski boot was made more flexible in order to reduce the incidence of boot top fractures [ 10 , 13 , 14 ]. Although these adjustments caused a reduced number of overall ankle and tibia fractures, the point of injury moved proximally resulting in an increased number of knee injuries and proximal tibia fractures [ 15 – 17 ]. Additionally, the recent use of carving skis has been associated with a rise in knee injuries, especially in female athletes, when bindings have not been recently adjusted [ 16 , 17 ].…”

Special Design of Ski Plates May Improve Skiing Safety

“…Another limitation of the study was the problems of drawing conclusions based on laboratory tests when compared to real skiing situations where numerous factors may play a role and very different injury mechanisms are possible [6,18,[25][26][27]. Nevertheless, a state-of-the-art measuring and testing device at an experienced and certified test house was employed for the experiment to ensure reliable and valid measurements.…”