Comparison of Tibial Shaft Ski Fractures in Children and Adults

Objective: To examine whether child and adult skiers have different risk factors or mechanisms of injury for tibial shaft fractures. Design: Descriptive epidemiological study. Setting: Prospectively analyzed the epidemiologic factors, injury types, and injury mechanisms at Sumi Memorial Hospital. Patients: This study analyzed information obtained from 276 patients with tibial fractures sustained during skiing between 2004 and 2012. Main Outcome Measures: We focused on 174 ski-related tibial shaft fractures with respect to the following factors: age, gender, laterality of fracture, skill level, mechanism of fracture (fall vs collision), scene of injury (steepness of slope), snow condition, and weather. Fracture pattern was graded according to Arbeitsgemeinschaft fur Osteosynthesefragen (AO) classification and mechanical direction [external (ER) or internal rotation (IR)]. Results: Tibial shaft fractures were the most common in both children (89.3%) and adults (47.4%). There were no significant differences in gender, side of fracture, mechanism of fracture, snow condition, or weather between children and adults. Skill levels were significantly lower in children than in adults (P < 0.0001). Type A fractures were more dominant in children (73 cases, 72.3%) than in adults (39 cases, 53.4%). There was significantly more ER in children than in adults (P < 0.0001). Among children, female patients had significantly more IR than ER; in contrast, among adults, women were injured by ER. Conclusions: We found significant differences in some of these parameters, suggesting that child and adult skiers have different risk factors or mechanisms of injury for tibial shaft fractures.