Downhill Ski Injuries in Children and Adolescents

Abstract

Downhill skiing is considered to be an enjoyable activity for children and adolescents, but it is not without its risks and injuries. Injury rates now range between 3.9 and 9.1 injuries per 1000 skier days, and there has been a well documented increase in the number of trauma cases and fatalities associated with this sport. Head and neck injuries are considered the primary cause of fatal injuries and constitute 11-20% of total injuries among children and adolescents. Cranial trauma is responsible for up to 54% of total hospital injuries and 67% of all fatalities, whereas thoracoabdominal and spine injuries comprise 4-10% of fatalities. Furthermore, there has been an increase in the proportion of upper extremity trauma with acromioclavicular dislocations, and clavicle and humeral fractures accounting for the majority (22-79%) of the injuries. However, the most common and potentially serious injuries in children and adolescents are those to the lower extremity, with knee sprains and anterior cruciate ligament tears accounting for up to 47.7% of total injuries. Knee sprains and grade III ligament trauma associated with lower leg fractures account for 39-77% of ski injuries in this young population. Approximately 15% of downhill skiing injuries among children and adolescents are caused by musculoskeletal immaturity. Other factors include excessive fatigue, age, level of experience, and inappropriate or improperly adjusted equipment. Collisions and falls constitute a significant portion (up to 76%) of trauma, and are commonly associated with excessive speed, adverse slope conditions, overconfidence leading to carelessness, and behavioural patterns within and among gender. The type and severity of injuries are typically functions of biomechanical efficiency, skiing velocity or slope conditions; however, a multiplicative array of intrinsic and extrinsic factors may simultaneously be involved. Despite extensive efforts to provide a comprehensive picture of the aetiology of injury, limitations have hampered reporting. These limitations include age and injury awareness, data collection challenges, lack of uniformity in the definition or delineation of age classification and lack of knowledge of predisposing factors prior to injury. Since skill level is the primary impetus in minimising ski injuries, formal instruction focusing on strategies such as collision avoidance and helmet use, fall training minimising lower extremity trauma, altering ski technique and avoiding behaviours that lead to excessive risk are, therefore, highly recommended. Skiing equipment should be outfitted to match the young skier's height, weight, level of experience, boot size and slope conditions. Additionally, particular attention should be paid to slope management (i.e. overcrowding, trail and obstacle marker upkeep) and minimising any opportunity for excessive speed where children are present. Whether increases in knowledge, education and technology will reduce predisposition to injury among this population remains to be seen. As with all high-ri...

A magyar alpesi sízők és hódeszkázók egészségkárosodásainak összehasonlító statisztikai elemzése

“…-irodalmi közlemények alapján a téli sportok veszélyességét relatíve magasnak tartjuk [16]. Az 1000 sportórára vetített sérülési arányt a síelésnél 3,7-től 8-ig, sőt gyermekkorúaknál 9,1-ig terjedő számban talál-tak [6,13,17]. A hódeszkás magyar élsportolók sérülési arányát 4-6/1000 sportórának találták [18].…”

“…Anyagunkban a térdsérülések 36,8%-ban fordultak elő, magyar adatok 57,3%, a nemzetközi felmérések pedig ezt az arányt 14,4-41%-ig terjedő tartományba helyezik, a gyermek sportolóknál ez az arány 47,7% volt [9,17,26,34]. Dániában, ahol a sportolók szintén külföldre járnak síelni, a térdsérülések aránya 40% volt.…”

Management of Anterior Cruciate Ligament Injuries in Skeletally Immature Individuals

“…The injury rates in children for alpine skiing have been reported to be 3.9 to 9.1 injuries per 1000 skier days, with the highest rates in children aged 1 to 10 years. 43,78 Although the incidence of ski injuries has decreased in adults, it has increased in children and adolescents over the last 2 decades. 39,43 A total rupture of the ACL is usually located at the proximal insertion site on the lateral wall of the intercondylar notch.…”

Personality Traits in Swedish High School Alpine Skiers – A Comparison between Injured and Uninjured Skiers

“…In alpine skiing, there is limited research on the influence of injuries with respect to personality characteristics and gender. Earlier research on skiing injuries has been focused on physiological aspects and inappropriate equipment, while very limited research deals with psychological risk factors [4]. It is, however, important to take as many aspects as possible into consideration when studying the complexity behind injuries in competitive alpine skiers.…”