title: Epidemiology of lower extremity injuries presenting to the emergency room in the United States: Snow skiing vs. snowboarding.
abstract: OBJECTIVE
  To quantify and compare the incidence of lower extremity injuries in skiers and snowboarders who present to emergency rooms in the United States.
  
  
  METHODS
  Cross-sectional study of lower extremity injuries in skiers and snowboarders that were evaluated in emergency rooms in the United States. The National Electric Injury Surveillance System (NEISS) database was queried from January 1st, 2014 and December 31st, 2014 and the reported cases of lower extremity injuries in skiers and snowboarders were examined.
  
  
  RESULTS
  An estimated total of 13,381 snow skiing and 6061 snowboarding lower extremity injuries presented to the emergency department in 2014 representing a national incidence of 42 injuries per 1,000,000 person-years for skiers and 19 injuries for snowboarders. The most common region of the lower extremity that was injured was the knee for skiers (47%) and the lower trunk (e.g. pelvis, hip, lumbar spine) for snowboarders (34%). The incidence of injuries in the pediatric and young adult population in skiers (62 per 1,000,000 person-years) and snowboarders (40 per 1,000,000 person-years) was significantly higher than the incidence of these injuries in adult population (35 and 12 per 1,000,000 person-years respectively) (P<0.01). The incidence of these injuries was significantly higher in males compared to females in both skiing (46 per 1,000,000 person-years vs. 38 per 1,000,000 person-years, P<0.01) and snowboarding (30 per 1,000,000 person-years vs. 9 per 1,000,000 person-years, P <0.01). The rate of injuries from 2010 to 2014 for skiers remained stable while snowboarding injuries down trended approaching significance.
  
  
  CONCLUSIONS
  The incidence of lower extremity injuries in skiers was higher than that of snowboarders in 2014, with the 0-19year old age group and males being those most likely to sustain an injury. The most common region of the lower extremity that was injured was the knee for skiers and the lower trunk (e.g. pelvis, hip, lumbar spine) for snowboarders. Physicians and consumers alike should be aware of this data when considering participation in these sports as well as strategies for injury prevention.
authors.affiliation: Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI 02903. Electronic address: sdefroda@gmail.com.
authors.forename: Steven F
authors.initials: SF
authors.lastname: DeFroda
authors.affiliation: Department of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI 02903. Electronic address: joseph_gil@brown.edu.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Gil
authors.affiliation: Department of Orthopaedic Surgery, Professor of Orthopaedic Surgery, Brown University, Warren Alpert School of Medicine, Providence, RI 02903. Electronic address: owensbrett@gmail.com.
authors.forename: Brett D
authors.initials: BD
authors.lastname: Owens
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001265:Athletic Injuries / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D012865:Skiing / Q000293:injuries* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D034941:Upper Extremity / Q000293:injuries*; D055815:Young Adult
keywords: Fracture; Lower extremity; Neiss; Skiing; Snowboarding; Sprain