Reduction of severe wrist injuries in snowboarding by an optimized wrist protection device: a prospective randomized trial.
BACKGROUND
The benefits of sport are well recognized, but many activities carry a sport-specific injury risk. Snowboarding has become an increasingly popular winter sport in Austria in recent years, with an estimated 900,000 participants annually. Roughly 6,000 of these suffer from injury and up to 2,000 sustain moderate or severe wrist injuries (mainly fractures of the distal radius and epiphysiolyses).


METHODS
We conducted a prospective, randomized, controlled trial to test the protective effect of a wrist protector, which differs in position, stiffness, length, and fixation from conventional protectors. Seven hundred twenty-one snowboarders were randomized into two groups. The risk factors and the injuries that occurred were registered by questionnaires and, in case of medical treatment, by medical reports. Time until injury (in half-days) was compared by the proportional hazards model.


RESULTS
Nine severe wrist injuries were sustained in the unprotected control group and only one in the protected group (hazard ratio, 0.13; 95% confidence limits, 0.02, 1.04). Twelve snowboarders of the protector group secretly discarded their protectors during the trial (including the snowboarder who suffered the one and only severe wrist injury of this group). A per-protocol analysis was therefore performed, which demonstrated a more accentuated result (p = 0.003). There was no statistically significant increase in the incidence of other types of injury. Experience was shown to be a further protective factor.


CONCLUSIONS
We recommend the use of a wrist protector, particularly for novices participating in this sport. As in other domains of medicine, preventive measures can decrease morbidity also in terms of sport injuries.
Machold
Wolfgang
W
Clinic for Traumatology, General Hospital, University of Vienna, Vienna, Austria. wolfgang.machold@akh-wien.ac.at
Kwasny
Oskar
O
Eisenhardt
Peter
P
Kolonja
Alexander
A
Bauer
Ewald
E
Lehr
Stephan
S
Mayr
Winfried
W
Fuchs
Martin
M
D000293:Adolescent; D001317:Austria / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011482:Protective Devices; D012307:Risk Factors; D012865:Skiing / Q000293:injuries*; D011795:Surveys and Questionnaires; D014954:Wrist Injuries / Q000453:epidemiology / Q000517:prevention & control*