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Skiing Injuries Andrew Getzin, MD

Skiing Injuries Andrew Getzin, MD. Cayuga Medical Center Sports Medicine and Athletic Performance www.cayugamed.org/sportsmedicine. Statistics Head injuries Skier’s thumb Knee injuries Prevention. Overview. 200 million skiers 70 million snowboarders in the world

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Skiing Injuries Andrew Getzin, MD

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  1. Skiing InjuriesAndrew Getzin, MD Cayuga Medical Center Sports Medicine and Athletic Performance www.cayugamed.org/sportsmedicine

  2. Statistics Head injuries Skier’s thumb Knee injuries Prevention Overview

  3. 200 million skiers 70 million snowboarders in the world 2 injuries for every 1000 ski days Increased risk with newer skiers and those who try to ski slopes beyond their ability Injury Statistics

  4. Skiing Injuries in Children Deibert, JBJS 1998A

  5. Skiing Injuries in Adolescents Deibert, JBJS 1998A

  6. Skiing Injuries in Adults Deibert, JBJS 1998A

  7. The leading cause of ski hospitalizations 50-88% of total deaths in skiers and snowboarders US Product Safety Commission estimates that 44% of these injuries could be eliminated with helmet use No increase risk for neck injuries Traumatic Brain injuries Cusimano and Kwok. JAMA 2010

  8. Male gender Youth Low skill level Use of rented equipment Absence of a helmet Risk Factor for Head Injuries in Skiing

  9. Almost all! Any loss of consciousness Memory problems Headaches Vomiting Why take chances? Which Skier’s with Head Injuries Need to be Seen by Medical Personnel?

  10. What is a Concussion? Mild traumatic brain injury A disruption in normal brain function due to a blow or jolt to the head CT or MRI is normal Invisible injury

  11. Common Physical Symptoms Headache Nausea and vomiting Clumsiness and poor balance Dizziness and lightheadedness Blurred vision and light sensitivity Fatigue and lack of energy Sleep disturbance Symptoms often get worse before they get better

  12. Who Should Have a CT Scan? What are we looking for? Intracranial bleed Cerebral edema Skull fracture <10% of patients with mTBI have CT abnormalities <1% require neurosurgical intervention Radiation exposure, Cost

  13. Principles of Concussion Treatment No cure for concussion, but treatment can help the person feel better and function better while symptomatic Early diagnosis and education is critical, and can improve outcome Rest early (7-10 days?) and then gradually increase activity

  14. Skiing into a planted pole Disruption or sprain to the ulnar collateral ligament (MCP joint) Pain with opening and grabbing things Skier’s thumb

  15. Skier’s Thumb: Exam Difficulty opposing pinky to thumb Swelling and black and blue over thenar eminence Can’t hold an OK sign

  16. Skier’s Radiology

  17. Skier’s Thumb: Treatment • Splint or cast 6-8 weeks • Ice, elevate, pain medication • Rare cases need surgery • Non-healing • Stenner’s lesion

  18. ACL injury Often feel a pop Usually can’t keep skiing Requires surgery Medial Collateral ligament Often can keep skiing Non-surgical brace Knee Injuries

  19. Most common knee injury 20% incidence in French ski team 40% recurrence ACL Injuries Pujol, AJSM 2007

  20. Phantom foot ACL Injury

  21. Boot-Induced ACL Injury

  22. Serious knee injury reduced by 62% in patrollers and instructors who participated in awareness training Study involved 42 areas and encompassed 24% US skiers Can education benefit the novice skier? http://www.vermontskisafety.com/kneefriendly.php ACL Awareness Training Ettingler AJSM 1995

  23. Arms forwards Skies together Hands over skis ACL Dos

  24. Don’t straighten your legs when you fall Don’t try to get up until you have stopped Don’t land on your hand Don’t jump unless you know how and where to land ACL Don’ts

  25. Take a lesson When skiing, look uphill before you ski and assess your surroundings Prepare your body for ski season Ease into the season: increase by <10%/week www.ski-injury.com General Injury Prevention

  26. Equipment Changes for Prevention

  27. Mountain bike use at resorts 80-90% Incentives- discounted tickets or helmets Include with all child and youth rental packages Insurance premiums to ski resorts Education Look at reduction in medical cost Ski patrollers role models Multi-faceted approach with ski helmets

  28. Sun Screen, only 65% of skiers Warm clothes Eye protection Warm up or Warm down Common Sense Hason and Sutherland, Curr Sports Med Reports 2010

  29. Never start a run after 3p Take the 3rd day off Beware above 3000 meters Fewer than 3 drinks the day before skiing Rule of 3s

  30. ENJOY YOUR SKI SEASON

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