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Skiing injuries

skiing photo

 Skiing and snowboarding are increasingly popular winter sports both in Scotland and abroad. Improving technology and safety equipment has seen a change in injury patterns.

In previous times it used to be that lower limb injuries were more common than upper limb injury. Now it has been reported that rates of upper limb injuries are similar to lower limb injury.
This reflects the improvement in lower limb protection. But also changes in styles of skiing and snowboarding. It has also been reported that the rates of upper limb injury in snowboarders is double that of skiers. Injury usually occurs in a fall or collision. The force can be directed either directly onto the shoulder or directly through the arm.
 

Injury patterns: Fractures

In snow boarders wrist fracture remains the most common  fracture, in contrast the most common fracture in skiers to occur is in the clavicle. Humeral fractures are also prevalent and occur in different patterns. Skiers get more proximal fractures (near the shoulder) whereas snowboarders have more mid shaft and distal fractures (closer to the elbow).

Dislocations

Anterior shoulder dislocation is a common hazard of winter sport and can occur when the arm is wrenched relative to the body. Severe pain and lack of movement are immediately apparent. Anterior dislocations can also be associated with fractures of the upper humerus.

Xray shows an anterior dislocation of the shoulder

A fall onto the point of the shoulder can lead to injury of the acromioclavicular joint (AC joint). This can result in a minor sprain ( grade I injury) where there is localised pain but no deformity. If deformity is present over the AC joint this may indicate a more severe disruption of the ACJ grade II or III. The diagnosis of all these injuries is a clinical and xray diagnosis.

The picture shows the typical deformity of a completely disrupted AC joint

Rotator Cuff injuries.

The tendons in the shoulder are subject to ageing and winter sports are not exclusive to the young. Frequent injuries to the rotator cuff are seen after falling on the shoulder or arm. Initial pain and difficulting with elevating the arm away from the body should alert one to the possibility of a rotator cuff injury. Initial xrays will be normal, diagnosis is clinical in conjuction with scans such as ultrasound or MRI.

 

Andy  Brooksbank

Febuary 2012

 

 

 

 

 

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