title: Tibial Fractures in Alpine Skiing and Snowboarding in Finland: A Retrospective Study on Fracture Types and Injury Mechanisms in 363 Patients.
abstract: OBJECTIVE
  Alpine skiing and snowboarding share the hazards of accidents accounting for tibial fractures. The aim of this study was to evaluate the fracture patterns and mechanisms of injury of tibial fractures taking place in downhill skiing and snowboarding.
  
  
  METHODS
  All patients with tibial fracture due to alpine skiing or snowboarding accident treated in four trauma centers next to the largest ski resorts in Finland were analyzed between 2006 and 2012. The hospital records were retrospectively reviewed for data collection: equipment used (skis or snowboard), age, gender, and mechanism of injury. Fractures were classified according to AO-classification.
  
  
  RESULTS
  There were 342 skiing and 30 snowboarding related tibial fractures in 363 patients. Tibial shaft fracture was the most common fracture among skiers (n = 215, 63%), followed by proximal tibial fractures (n = 92, 27%). Snowboarders were most likely to suffer from proximal tibial fracture (13, 43%) or tibial shaft fracture (11, 37%). Snowboarders were also more likely than skiers to suffer complex AO type C fractures (23% vs 9%, p < 0.05). Adult skiers had both wider variety of fractures and higher prevalence of proximal tibial fractures compared to children (49% vs 16%, p < 0.05). Skiers typically got injured due to falling down on the same level (70%) and snowboarders due to loss of control while jumping (46%).
  
  
  CONCLUSIONS
  The most important finding was the relatively high number of the tibial plateau fractures among adult skiers. The fracture patterns between snowboarding and skiing were different; the most common fracture type in skiers was spiral tibial shaft fracture compared to proximal tibial fractures in snowboarders. Children had more simple fractures than adults.
authors.affiliation: Department of Orthopedics and Traumatology, Helsinki University and Helsinki University Hospital, Helsinki, Finland antti.stenroos@hus.fi.
authors.forename: A
authors.initials: A
authors.lastname: Stenroos
authors.affiliation: Department of Orthopedics and Traumatology, Oulu University Hospital, Oulu, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Pakarinen
authors.affiliation: Department of Pediatric Surgery, Kuopio University Hospital, Kuopio, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Jalkanen
authors.affiliation: Department of Orthopaedics and Traumatology, Rovaniemi Central Hospital, Rovaniemi, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Mälkiä
authors.affiliation: Department of Orthopedics and Traumatology, Helsinki University and Helsinki University Hospital, Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Handolin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012865:Skiing / Q000293:injuries*; D013978:Tibial Fractures / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: Skiing; injury mechanism; lower leg fracture; snowboarding; tibial fracture