title: Comparison of tibial shaft ski fractures in children and adults.
abstract: OBJECTIVE
  To examine whether child and adult skiers have different risk factors or mechanisms of injury for tibial shaft fractures.
  
  
  METHODS
  Descriptive epidemiological study.
  
  
  METHODS
  Prospectively analyzed the epidemiologic factors, injury types, and injury mechanisms at Sumi Memorial Hospital.
  
  
  METHODS
  This study analyzed information obtained from 276 patients with tibial fractures sustained during skiing between 2004 and 2012.
  
  
  METHODS
  We focused on 174 ski-related tibial shaft fractures with respect to the following factors: age, gender, laterality of fracture, skill level, mechanism of fracture (fall vs collision), scene of injury (steepness of slope), snow condition, and weather. Fracture pattern was graded according to Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification and mechanical direction [external (ER) or internal rotation (IR)].
  
  
  RESULTS
  Tibial shaft fractures were the most common in both children (89.3%) and adults (47.4%). There were no significant differences in gender, side of fracture, mechanism of fracture, snow condition, or weather between children and adults. Skill levels were significantly lower in children than in adults (P < 0.0001). Type A fractures were more dominant in children (73 cases, 72.3%) than in adults (39 cases, 53.4%). There was significantly more ER in children than in adults (P < 0.0001). Among children, female patients had significantly more IR than ER; in contrast, among adults, women were injured by ER.
  
  
  CONCLUSIONS
  We found significant differences in some of these parameters, suggesting that child and adult skiers have different risk factors or mechanisms of injury for tibial shaft fractures.
authors.affiliation: *Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan; and †Department of Orthopaedic Surgery, Sumi Memorial Hospital, Gifu, Japan.
authors.forename: Tomo
authors.initials: T
authors.lastname: Hamada
authors.forename: Kazu
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Daichi
authors.initials: D
authors.lastname: Ishimaru
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sumi
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012865:Skiing / Q000293:injuries*; D013978:Tibial Fractures / Q000145:classification / Q000453:epidemiology*; D014887:Weather; D055815:Young Adult