title: The impact of orthopaedic injuries sustained at an urban public ice skating rink: is it really free?
abstract: BACKGROUND
  Previous reports in the literature from Europe and Asia cite an increased burden on the local emergency departments and orthopaedic services during the operational period of the ice skating rinks. This retrospective observational study was undertaken in order to report the incidence, characteristic, and severity of injuries during a full season at a large urban ice skating rink, as well as to quantify the added burden the ice skating rink places on the local emergency department and the orthopaedic service.
  
  
  METHODS
  All patients seen at our emergency room who sustained an injury at the neighboring "free" ice rink were identified over the 4-month period when it was open. The data collected included type of injury, demographics, and need for surgical treatment.
  
  
  RESULTS
  Over this period, 118 patients were seen in our ED (of the 135 referrals from the ice rink logbook); Of these, 43 (38%) required an orthopaedic consult and were evenly divided into upper (22) and lower extremity injuries (21). Sixty-seven percent of the patients were adults, and the most common fractures were ankle and distal radius fractures. There were two open fractures of the distal radius seen in the older patients (both in patients > 50). Overall 32% of patients needed operative treatment. Of the non-orthopaedic injuries, the most common was head injury (25%).
  
  
  CONCLUSIONS
  An ice-rink may be "free" but adds significant burden to the healthcare system, and these costs should be factored in by both the sponsoring body and the healthcare system for treatment of these additional patients.
authors.forename: Ran
authors.initials: R
authors.lastname: Schwarzkopf
authors.forename: Elliot A
authors.initials: EA
authors.lastname: Nacke
authors.forename: Nirmal C
authors.initials: NC
authors.lastname: Tejwani
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D017281:Cost of Illness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012861:Skating / Q000293:injuries*; D013997:Time Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult