title: Injury patterns and risk factors for orthopaedic trauma from snowboarding and skiing: a national perspective.
abstract: OBJECTIVE
  Alpine skiing and snowboarding are both popular winter sports that can be associated with significant orthopaedic injuries. However, there is a lack of nationally representative injury data for the two sports.
  
  
  METHODS
  The National Trauma Data Bank was queried for patients presenting to emergency departments due to injuries sustained from skiing and snowboarding during 2011 and 2012. Patient demographics, comorbidities, and injury patterns were tabulated and compared between skiing and snowboarding. Risk factors for increased injury severity score and lack of helmet use were identified using multivariate logistic regression.
  
  
  RESULTS
  Of the 6055 patients identified, 55.2 % were skiers. Sixty-one percent had fractures. Lower extremity fractures were the most common injury and occurred more often in skiers (p < 0.001). Upper extremity fractures were more common in snowboarders, particularly distal radius fractures (p < 0.001). On multivariate analysis, increased injury severity was independently associated with age 18-29, 60-69, 70+, male sex, a positive blood test for alcohol, a positive blood test for an illegal substance, and wearing a helmet. Lack of helmet use was associated with age 18-29, 30-39, smoking, a positive drug test for an illegal substance, and snowboarding.
  
  
  CONCLUSIONS
  Young adults, the elderly, and those using substances were shown to be at greater risk of increased injury severity and lack of helmet use. The results of this study can be used clinically to guide the initial assessment of these individuals following injury, as well as for targeting preventive measures and education.
  
  
  METHODS
  Prognostic Level III.
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite 300, Chicago, IL, 60612, USA.
authors.forename: Bryce A
authors.initials: BA
authors.lastname: Basques
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Avenue, New Haven, CT, 06510, USA.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Gardner
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Avenue, New Haven, CT, 06510, USA.
authors.forename: Andre M
authors.initials: AM
authors.lastname: Samuel
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Avenue, New Haven, CT, 06510, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Webb
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Avenue, New Haven, CT, 06510, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Lukasiewicz
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite 300, Chicago, IL, 60612, USA.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Bohl
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Avenue, New Haven, CT, 06510, USA. jonathan.grauer@yale.edu.
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Grauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000453:epidemiology; D001265:Athletic Injuries / Q000453:epidemiology*; D016208:Databases, Factual; D004636:Emergency Service, Hospital; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D012307:Risk Factors; D012865:Skiing / Q000293:injuries*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol; Drugs; Fracture; Helmet; Skiing; Snowboarding