title: [Proximal tibial fractures sustained during alpine skiing - incidence and risk factors].
abstract: BACKGROUND
  Prior to introduction of carving skis, complex fractures of the proximal tibia were rarely seen. Recently these fractures are being seen more frequently in connection with alpine skiing. The aim of this study was to find out the incidence of proximal tibia fractures in alpine skiing and to identify possible risk factors.
  
  
  METHODS
  All patients with proximal tibia fractures related to alpine skiing in a large German ski resort were included. Fracture type, patient and skiing related factors were recorded. Incidence of fractures was determined by using the number of all registered skiers. Multinomial logistic regression analysis was used to calculate the odds ratios for risk factors.
  
  
  RESULTS
  Between 2007 and 2010 a total of 188 patients was treated for proximal tibia fractures caused by alpine skiing. Forty-three patients had a type-A injury, 96 patients a type-B injury, and 49 patients a type-C injury. The incidence of injury increased continuously, starting from 2.7 and climbing to 7.0 per 10⁵ skiing days. The risk factors compared to patients with type-A fractures, type-C fracture occurred in older (OR 0.93; 0.89 - 0.97) and heavier (OR 0.86; 0.74 - 0.99) individuals and were more likely on icy snow conditions (OR 0.22; 0.05 - 0.96), higher speed (OR 0.29; 0.09 - 0.97) and skiing skill (OR 0.35; 0.13 - 0.95). These was also seen in artificial and icy snow conditions (OR 0.25; 0.07 - 0.87) when compared to type-B fractures.
  
  
  CONCLUSIONS
  The incidence of proximal tibia fractures related to skiing has increased over the past four years. Risk factors such as age, BMI, snow conditions, speed, and the skill of the skiers, were identified as causes contributing to complex fractures.
authors.affiliation: BG Unfallklinik Murnau.
authors.forename: R
authors.initials: R
authors.lastname: Pätzold
authors.affiliation: Abteilung für Unfall- und Rekonstruktionschirurgie, Universität Leipzig.
authors.forename: U
authors.initials: U
authors.lastname: Spiegl
authors.affiliation: Endogap Abteilung für Gelenkersatz, Klinikum Garmisch-Partenkirchen.
authors.forename: M
authors.initials: M
authors.lastname: Wurster
authors.affiliation: Institut für Biomechanik, Paracelsus medizinische Universität Salzburg, Österreich.
authors.forename: P
authors.initials: P
authors.lastname: Augat
authors.affiliation: Abteilung für Unfallchirurgie, Klinikum Garmisch-Partenkirchen.
authors.forename: P
authors.initials: P
authors.lastname: Gutsfeld
authors.affiliation: BG Unfallklinik Murnau.
authors.forename: O
authors.initials: O
authors.lastname: Gonschorek
authors.affiliation: BG Unfallklinik Murnau.
authors.forename: V
authors.initials: V
authors.lastname: Bühren
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001265:Athletic Injuries / Q000453:epidemiology*; D054874:Athletic Performance / Q000706:statistics & numerical data*; D002648:Child; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007718:Knee Injuries / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D012865:Skiing / Q000293:injuries*; D012914:Snow; D013978:Tibial Fractures / Q000453:epidemiology*; D055815:Young Adult