title: Analysis of Injury Mechanisms in Head Injuries in Skiers and Snowboarders.
abstract: Mechanisms of injury and description of head impacts leading to traumatic brain injury (TBI) in skiers and snowboarders have not been extensively documented. We investigate snow sport crashes leading to TBI 1) to identify typical mechanisms leading to TBI to better target prevention measures and 2) to identify the injury mechanisms and the head impact conditions.
  
  
  
  The subjects were skiers and snowboarders diagnosed of TBI and admitted between 2013 and 2015 to one of the 15 medical offices and three hospital centers involved in the study. The survey includes the description of the patients (age, sex, practice, skill level, and helmet use), the crash (type, location, estimated speed, causes, and fall description), and the injuries sustained (symptoms, head trauma scores, and other injuries). Sketches were used to describe the crash and impact locations. Clustering methods were used to distinguish profiles of injured participants.
  
  
  
  A total of 295 skiers and 71 snowboarders were interviewed. The most frequent type of mechanism was falls (54%), followed by collision between users (18%) and jumps (15%). Collision with obstacle (13%) caused the most serious TBI. Three categories of patients were identified. First, men age 16-25 yr are more involved in crash at high speed or in connection with a jump. Second, women, children (<16 yr), and beginners are particularly injured in collisions between users. Third, those older than 50 yr, usually nonhelmeted, are frequently involved in falls. Ten crash scenarios were identified. Falling head first is the most frequent of skiers' falls (28%).
  
  
  
  Crash scenarios leading to TBI were identified and associated with profiles of injured participants. Those results should help to better target TBI prevention and protection campaigns.
authors: 1Aix-Marseille Univ, IFSTTAR, LBA UMR_T24, F-13016 Marseille, FRANCE; 2Salomon S.A.S., Annecy, FRANCE; 3"Médecins de Montagne" Association, Chambéry, FRANCE; 4Department of Neurosurgery, Hôpital Nord, Marseille, FRANCE; 5Department of Mobile Emergency and Intensive Care Units, Annecy Hospital, Annecy, FRANCE; and 6Department of Neurosurgery, University Hospital of Grenoble, Grenoble, FRANCE.
authors: Nicolas
authors: N
authors: Bailly
authors: Sanae
authors: S
authors: Afquir
authors: Jean-Dominique
authors: JD
authors: Laporte
authors: Anthony
authors: A
authors: Melot
authors: Dominique
authors: D
authors: Savary
authors: Eric
authors: E
authors: Seigneuret
authors: Jean-Baptiste
authors: JB
authors: Delay
authors: Thierry
authors: T
authors: Donnadieu
authors: Catherine
authors: C
authors: Masson
authors: Pierre-Jean
authors: PJ
authors: Arnoux
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002648:Child; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005602:France / Q000453:epidemiology; D006260:Head Protective Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D012865:Skiing / Q000293:injuries* / Q000706:statistics & numerical data; D055815:Young Adult