Ski Injuries in Uludağ and Causes: In this study, 759 ski injuries occurred in Uludağ during the years between 1987 and 1992 have been revisited. It has been identified that 70.2% of all ski-related injuries were soft tissue injuries and that the lack of skiing experience, use of rental equipment, and good weather conditions have all played a role in those injuries. Dating back to approximately 4000 years, skiing was first used as a means of transportation. The first recorded skiing competition took place in 1767, in Norway. This sport, which was predominantly performed in the Northern Europe initially, became widespread attraction in the United States,e especially after the 1932 Winter Olympics hosted in Lake Placid, New York. The most common factors of skiing injuries are environmental conditions, the types of equipment used and the experience level of the skiers. The term “environmental conditions” refers to the snow quality, weather conditions, sight distance, skiing time and period. For instance, the most common injuries occurring on icy grounds are upper extremities and head traumas, while lower extremities and tibia or knee injuries are more common in soft and powder-heavy grounds. Regarding the type of equipment used, there is a correlation between the risk of injury and whether the equipment can be removed in case of a fall. Hauser have shown that most of the lower extremity injuries can be prevented, provided that the equipment meets specific requirements. According to the studies conducted on this topic, the risk of injury is two times higher among inexperienced skiers in comparison to experienced ones. Especially among inexperienced skiers, the knee joint of valgus struggles to keep up with the inside rotation pressure, and consequently, injuries are common in the medial collateral ligaments. This study has been designed because of the lack of a comprehensive study on ski injuries in our country. Therefore, the ski injuries occurred in Uludağ, one of the most popular ski centers of our country, between the years 1987 and 1992 were analyzed.
Materials
The 759 cases referred to Sabancı Emergency Care Unit of the Faculty Medicine of Uludağ University between the years 1987 and 1992 were evaluated within the scope of this study. 409 of the cases were male (53.8%) while 350 cases were female (46.2%). Each skier was given the questionnaire below for the purpose of conducting a comprehensive evaluation.
Findings
In the study, it has been identified that the most common risk group consisted of individuals aging between 21 and 40. 60.8% of the soft tissue injuries were observed in the knee joint. 62.6% of the fractures were found to have occurred in the lower extremity, while the remaining 37.4% were in the upper extremity.
Discussion The fact that males were more susceptible to suffer a ski-related injury according to our study, is consistent with the findings of other studies, except for the exact percentages. For instance, the rate of injury among males were reported at 67%, 61.7%, and 62% by Sahlin, Figueras and Ungerholm, respectively, which was at 53.8% according to our study. Moreover, the fact that the rate of injury among females was found to be closer to that of males shows that this sport has become popular among women of our society. On the other hand, the fact that the injuries are more common among the individuals aging between 21 and 40, suggests that skiing is a more common activity in this age group. The rate of injury due to failure of the equipment be removed during the fall was found at 56.9%, which is consistent with the results found by Ungerholm and Matter. This rate was reported at 57% and 64% by Ungerholm and Matter, respectively. Additionally, the rate of injury due to rental equipment usage found at 64.9% in our study, suggests that rugged, inappropriate rental equipment usage is a significant factor in the ski injuries. The high rate of injury among the inexperienced skiers, found at 86.8% in our study, is consistent with the findings of other studies. This rate was reported at 93% and 75% by Johnson and Ungerholm, respectively. We believe that the reason for the injuries being more common during good weather conditions (85.4%) is related with the crowded tracks, loss of attention and increased physical demand due to extra time of skiing. The rate of soft tissue injuries identified at 70.2% in our research which focused on the cases occurred during a five-year period has shown similarities with the findings of other studies. This rate was reported at 76.6%, 52% and 51.4 by Johnson, Geyer, and Matter, respectively. We believe that the reason for the soft tissue injuries being more common in the knee joint is related with the lack of access to good equipment and the skiing technique that puts too much pressure on the valgus employed predominantly by the inexperienced skiers. The fact that fractures being observed more commonly in the lower extremities (62.6%) is consistent with the findings of other studies. This rate was reported at 86%, and 58% by Matter and Johnson, respectively. The rate of lateral malleolus fibula fractures caused by low ski boots and found at 22.3% in our study was reported at 22%, and 17% by Westlin and Matter, respectively. The rate of mid tibia fractures observed in today’s high ski boots was found at 50.9% in our study. Matter reported this rate at 65%. The rate of upper extremity fractures, which is found less common in comparison to lower extremity cases (37.4%), was reported at 42%, and 14% by Johnson and Matter, respectively. We believe that the difference between these results are due to the various weather and track conditions. The rate of cases of dislocation especially around the shoulder area identified at 6% in our study supports the results reported by Johnson, who recorded it at 7.4%.
Conclusion
1. Among inexperienced skiers using rental equipment in good weather conditions the probability of injury is higher.
2. Injuries are mostly caused by falls.
3. The soft tissue injuries are the most common type and are often observed on the knee area.
4. The fractures are usually occur on the low extremity and mid tibia.
Source: Acta Orthop Traumatol Turc 27, 107-109, 1993 Öner Gedikoğlu, Ufuk Aydınlı, Ömer Faruk Bilgen, Bartu Sarısözen