title: Reduction of severe wrist injuries in snowboarding by an optimized wrist protection device: a prospective randomized trial.
abstract: 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.
authors.affiliation: Clinic for Traumatology, General Hospital, University of Vienna, Vienna, Austria. wolfgang.machold@akh-wien.ac.at
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Machold
authors.forename: Oskar
authors.initials: O
authors.lastname: Kwasny
authors.forename: Peter
authors.initials: P
authors.lastname: Eisenhardt
authors.forename: Alexander
authors.initials: A
authors.lastname: Kolonja
authors.forename: Ewald
authors.initials: E
authors.lastname: Bauer
authors.forename: Stephan
authors.initials: S
authors.lastname: Lehr
authors.forename: Winfried
authors.initials: W
authors.lastname: Mayr
authors.forename: Martin
authors.initials: M
authors.lastname: Fuchs
mesh_terms: 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*