title: Vancouver winters: environmental influences on inpatient adult orthopaedic trauma demographics.
abstract: OBJECTIVE
  To compare the pattern of adult inpatient orthopaedic injuries admitted at three Vancouver hospitals following one of the worst winter snowstorms in the region with the preceding control winter period.
  
  
  METHODS
  The surveillance study was conducted at the University of British Columbia, Vancouver, Canada, 2007 to 2010. Inpatient adult admissions for orthopaedic injuries at three hospitals were recorded, including age, gender, anatomic location of injury, type of fracture (open or closed), fixation method (internal versus external fixation), and length of acute care hospital stay. Comparisons between admissions during this weather pattern and admission during a previous winter with minimal snow were made. SPSS 19 was used for statistical analysis.
  
  
  RESULTS
  Of the 511 patients admitted under Orthopaedic trauma service during the significant winter snowstorms of December 2008-January 2009, 100 (19.6%) (Cl: 16.2%-23.2%) were due to ice and snow, whereas in the preceding mild winter only 18 of 415 (4.3%) (CI: 2.5%-6.8%) cases were related to snow (p < 0.05). Ankle and wrist fractures were the most frequent injuries during the index snow storm period (p < 0.05). At all the three institutions, 97 (96.5%) fractures were closed during the snowstorm as opposed to 17 (95%) during the control winter period. Internal fixation in 06 (89%) fractures as opposed to external fixation in 12 (11%) patients was the predominant mode of fixation across the board during both time periods.
  
  
  CONCLUSIONS
  The study demonstrated a significantly higher inpatient orthopaedic trauma volume during the snowstorm. More rigorous prospective studies need to be designed to gain further insight to solving these problems from a public health perspective.
authors.forename: Shahryar
authors.initials: S
authors.lastname: Noordin
authors.forename: Bassam A
authors.initials: BA
authors.lastname: Masri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012621:Seasons; D012914:Snow; D014505:Urban Population / Q000706:statistics & numerical data