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Winter Sport Musculoskeletal Injuries: Epidemiology and Factors Predicting Hospital Admission
John T Hurt, BS1, Alexander R. Graf, MD2, Alex Dawes, BS3, Roy Toston, BS4, Michael Gottschalk, MD5 and Eric R. Wagner, MD1, (1)Emory University, Atlanta, GA, (2)Medical College of Wisconsin, Milwaukee, WI, (3)Emory University School of Medicine, Atlanta, GA, (4)Emory University School Medicine, Atlanta, GA, (5)Orthopedic Surgery, Emory School of Medicine, Atlanta, GA

INTRODUCTION: Participation in winter sports such as skiing, snowboarding, and snowmobiling is associated with significant risk of musculoskeletal injury. Given the paucity of literature on this topic, we aimed to describe and quantify emergency department encounters associated with these sports to better understand injury patterns and factors associated with hospital admission.
METHODS: The National Electronic Injury Surveillance System was queried for skiing, snowboarding and snowmobiling-related injuries from 2009 to 2018. Patient demographics, diagnosis, injury location, and disposition data were collected from emergency department encounters. Descriptive statistics were utilized to describe the trends in injuries from each sport, and factors associated with the sports-specific injuries.
RESULTS: From 2009 to 2018, there were an estimated 156,353 injuries related to snowboarding, skiing, or snowmobiling. Estimated incidence (per 100,000) decreased for skiing (3.24 to 1.23), snowboarding (3.98 to 1.22) and snowmobiling (0.71 to 0.22). Skiing injuries were most common in adults, snowboarding injuries in adolescents and snowmobiling injuries in millennials. The prevailing injury location by sport was shoulder for skiing and snowmobiling (29.6%, 21.9%), and wrist for snowboarding (32.5%), fractures being the most common diagnosis. Only 4.5% required hospital admission. Fracture or dislocation were associated with highest likelihood of hospital admission (OR:42.34; 95%CI:22.59-79.37). Snowmobiling injuries (OR:1.63; 95%CI:1.20-2.22) and white race (OR:1.42;95%CI:1.17-1.72) were both associated with increased risk of hospital admission.
CONCLUSION: Incidence of musculoskeletal injuries presenting to the emergency department in all three sports decreased over the 10-year study period. Upper extremity injuries, particularly fractures, were more common than lower extremity injuries for all three sports, with the shoulder being the most common location of injury for skiing and snowmobiling. Although less frequent, snowmobiling injuries had the highest percentage requiring hospital admission. This study can serve as the foundation for future research in sports safety and health policy to continue the decline of musculoskeletal injuries in the future.


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