title: Sledding injuries a practice-based study is it time to raise awareness?
abstract: BACKGROUND
  The purpose of this review is to describe our practice-based incidence of sledding injuries in children.
  
  
  METHODS
  An 8-year (2003-2011) retrospective review of all hospitalized children (<18 years) from a level one pediatric trauma center due to sledding injuries was performed. Demographic, injury severity score (ISS), hospital stay, ICU stay, and discharge status were analyzed and compared to all other trauma hospitalizations.
  
  
  RESULTS
  Fifty-two children were hospitalized from sledding injuries. There were 34 males and 18 females with an average age of 10.1 ± 3.7 years. Impact with a tree was the most common mechanism of injury in 33/52 (63.5 %). Strikingly 20 (37 %) patients suffered a head injury with average ISS scores of 13.21 ± 2.30 and 70 % of them were admitted to the ICU. Three children had permanent disability including cognitive impairment and two others required long-term hospitalization rehabilitation. Other injuries included fractures (17), solid organs (10), chest trauma (1), and vertebral fractures (3).
  
  
  CONCLUSIONS
  Sledding was a significant component of hospitalized children during winter months. 30 % suffered significant head inquires and nearly 10 % had permanent disabilities. Injury control strategies ensuring safe environments away from trees, and head protection should be publicized.
authors.affiliation: Section of Pediatric Surgery, Department of Surgery, The University of Michigan Medical School, The C.S. Mott Children's Hospital, 4-495 Mott Children's Hospital, 1540 Hopsital drive, Ann Arbor, MI, 48109, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Herman
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Hirschl
authors.forename: Peter F
authors.initials: PF
authors.lastname: Ehrlich
mesh_terms: D001265:Athletic Injuries / Q000453:epidemiology*; D002648:Child; D006259:Craniocerebral Trauma / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008824:Michigan / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D038161:Snow Sports / Q000293:injuries* / Q000706:statistics & numerical data*; D014193:Trauma Centers / Q000706:statistics & numerical data