Limits...
Knee Injuries in Downhill Skiers: A 6-Year Survey Study.

Shea KG, Archibald-Seiffer N, Murdock E, Grimm NL, Jacobs JC, Willick S, Van Houten H - Orthop J Sports Med (2014)

Bottom Line: Children and adults showed no significant difference in distribution of injury mechanism.Individuals between the ages of 30 and 40 years showed an increased risk for the phantom foot mechanism, and the prevalence of injuries was significantly higher for females compared with males in this cohort (P < .01).Binding release was more likely to occur in youth skiers.

View Article: PubMed Central - PubMed

Affiliation: St Luke's Health System, Boise, Idaho, USA. ; University of Utah School of Medicine, Salt Lake City, Utah, USA. ; University of Utah Department of Orthopedics, Salt Lake City, Utah, USA.

ABSTRACT

Background: Knee injuries account for approximately one third of injuries in skiers. Researchers have proposed several mechanisms of knee injury in skiers. However, the frequencies of these mechanisms have varied in different studies.

Purpose: To identify the most common knee injury mechanisms in recreational downhill skiers and to assess injury frequencies across several demographics.

Study design: Descriptive epidemiology study.

Methods: Over 6 ski seasons, 541 patients with acute knee injuries completed a survey. Patients selected 1 of 6 injury classifications; age, sex, height, weight, years of experience, ability level, and ski binding release were also recorded.

Results: The overall injury distribution was valgus-external rotation (32.9%), phantom foot (22.5%), hyperextension (19.0%), boot induced (7.8%), collision (2.2%), and other (15.6%). The phantom foot mechanism was most common in ages 30 to 40 years (36.3% of all injuries within this mechanism; P < .01). Children and adults showed no significant difference in distribution of injury mechanism. Of 80 youth skiers, valgus-external rotation was most common (35.4%), followed by phantom foot (25.3%). Adult and youth skiers who identified as "advanced" skiers had a higher prevalence of valgus-external rotation than did less experienced skiers (51.5% of total valgus injuries; P < .01). Bindings released in 19.3% in adults and 53.7% in youths (P < .01) during injury. Female skiers comprised 60.0% of total respondents, but only 39.7% of injuries occurred in female children (P < .01).

Conclusion: Valgus-external rotation is the most common injury mechanism for recreational skiers in general. Previous studies have suggested that the phantom foot injury is the most common injury, but in this series, it was the second most common, representing 22.5% of injuries in this study. Individuals between the ages of 30 and 40 years showed an increased risk for the phantom foot mechanism, and the prevalence of injuries was significantly higher for females compared with males in this cohort (P < .01). Children and adults appear to have similar mechanisms for ski-related knee injuries, with valgus-external rotation being most common and advanced skiers having the highest frequency of this mechanism. Binding release was more likely to occur in youth skiers.

No MeSH data available.


Related in: MedlinePlus

Boot induced: Landing from a jump, the ski tail contacts the snow first.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
getmorefigures.php?uid=PMC4555526&req=5

fig3-2325967113519741: Boot induced: Landing from a jump, the ski tail contacts the snow first.

Mentions: The boot-induced mechanism6,9,10,12,13,19,21,23,24,28 (Figure 3) is unique from deceleration/change in direction injuries, both in mechanism as well as consequential injuries.12 After a skier loses contact with the ground with both skis, such as while going off of a jump, the ski tails are often the first portions of the skis to contact the snow on landing. This causes a sudden shift of body weight backward, while the lower legs are bound to the skis. As the skier completes the landing, the ski tips are forced down, allowing the rear of the boot to apply an anterior force on the tibia. The anteriorly directed force on the tibia from the back of the ski boot is accentuated by an anterior pull on the proximal tibia by the quadriceps muscles, which is usually strongly activated to prevent the skier from falling backward. This creates a scenario in which the upper body is shifting backward and the lower leg is being forced anteriorly by the lever arm of the ski tail, isolating the ACL for injury. Because there is generally no valgus force involved, the MCL and lateral structures are usually left unharmed, unless additional damage is sustained in the ensuing fall.6,24


Knee Injuries in Downhill Skiers: A 6-Year Survey Study.

Shea KG, Archibald-Seiffer N, Murdock E, Grimm NL, Jacobs JC, Willick S, Van Houten H - Orthop J Sports Med (2014)

Boot induced: Landing from a jump, the ski tail contacts the snow first.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555526&req=5

fig3-2325967113519741: Boot induced: Landing from a jump, the ski tail contacts the snow first.
Mentions: The boot-induced mechanism6,9,10,12,13,19,21,23,24,28 (Figure 3) is unique from deceleration/change in direction injuries, both in mechanism as well as consequential injuries.12 After a skier loses contact with the ground with both skis, such as while going off of a jump, the ski tails are often the first portions of the skis to contact the snow on landing. This causes a sudden shift of body weight backward, while the lower legs are bound to the skis. As the skier completes the landing, the ski tips are forced down, allowing the rear of the boot to apply an anterior force on the tibia. The anteriorly directed force on the tibia from the back of the ski boot is accentuated by an anterior pull on the proximal tibia by the quadriceps muscles, which is usually strongly activated to prevent the skier from falling backward. This creates a scenario in which the upper body is shifting backward and the lower leg is being forced anteriorly by the lever arm of the ski tail, isolating the ACL for injury. Because there is generally no valgus force involved, the MCL and lateral structures are usually left unharmed, unless additional damage is sustained in the ensuing fall.6,24

Bottom Line: Children and adults showed no significant difference in distribution of injury mechanism.Individuals between the ages of 30 and 40 years showed an increased risk for the phantom foot mechanism, and the prevalence of injuries was significantly higher for females compared with males in this cohort (P < .01).Binding release was more likely to occur in youth skiers.

View Article: PubMed Central - PubMed

Affiliation: St Luke's Health System, Boise, Idaho, USA. ; University of Utah School of Medicine, Salt Lake City, Utah, USA. ; University of Utah Department of Orthopedics, Salt Lake City, Utah, USA.

ABSTRACT

Background: Knee injuries account for approximately one third of injuries in skiers. Researchers have proposed several mechanisms of knee injury in skiers. However, the frequencies of these mechanisms have varied in different studies.

Purpose: To identify the most common knee injury mechanisms in recreational downhill skiers and to assess injury frequencies across several demographics.

Study design: Descriptive epidemiology study.

Methods: Over 6 ski seasons, 541 patients with acute knee injuries completed a survey. Patients selected 1 of 6 injury classifications; age, sex, height, weight, years of experience, ability level, and ski binding release were also recorded.

Results: The overall injury distribution was valgus-external rotation (32.9%), phantom foot (22.5%), hyperextension (19.0%), boot induced (7.8%), collision (2.2%), and other (15.6%). The phantom foot mechanism was most common in ages 30 to 40 years (36.3% of all injuries within this mechanism; P < .01). Children and adults showed no significant difference in distribution of injury mechanism. Of 80 youth skiers, valgus-external rotation was most common (35.4%), followed by phantom foot (25.3%). Adult and youth skiers who identified as "advanced" skiers had a higher prevalence of valgus-external rotation than did less experienced skiers (51.5% of total valgus injuries; P < .01). Bindings released in 19.3% in adults and 53.7% in youths (P < .01) during injury. Female skiers comprised 60.0% of total respondents, but only 39.7% of injuries occurred in female children (P < .01).

Conclusion: Valgus-external rotation is the most common injury mechanism for recreational skiers in general. Previous studies have suggested that the phantom foot injury is the most common injury, but in this series, it was the second most common, representing 22.5% of injuries in this study. Individuals between the ages of 30 and 40 years showed an increased risk for the phantom foot mechanism, and the prevalence of injuries was significantly higher for females compared with males in this cohort (P < .01). Children and adults appear to have similar mechanisms for ski-related knee injuries, with valgus-external rotation being most common and advanced skiers having the highest frequency of this mechanism. Binding release was more likely to occur in youth skiers.

No MeSH data available.


Related in: MedlinePlus