Background: Most traumatic injuries in alpine skiing and snowboarding affect the lower extremity, especially the knee. Snowboard appeared in the 1970’s, then gained truly in popularity in the 1990’s. The most common injury in snowboarding is located around the wrist. Alpine skiing has seen a change in equipment from the year 2000 on, with the appearance of carving skis. While it generated a rise in internal knee injuries, it has yet to be proven if this had an impact on upper extremity injuries.
Purpose: Determine the epidemiology of upper extremity injuries in both alpine ski and snowboard, its chronological evolution in the last two decades and the impact of carving on ski injuries.
Study design: Systematic review
Methods: A systematic search in Pubmed was conducted using the key words “skiing”, “snowboard”, all anatomical entities of the upper extremity and all type of injuries. Both prospective and retrospective studies were included, while case reports were excluded. Only articles focusing on alpine ski, snowboard or telemark injuries, and providing statistical data about the upper extremity were included. Exclusion criteria were other kind of winter sports, Paralympic sports, artificial or indoor slopes
Results: The literature review represented a period from 1939 to 2017 with a total of 673 270
patients. The upper limb represents 23% of all ski injuries and 33% of all snowboard injuries. The most injured upper extremity segments are the shoulder (35%) and the hand (32%) for skiing and the wrist (40%) and the shoulder (31%) for snowboarding. In both sports, most fractures happen far from the elbow, meaning the proximal humerus and the distal radius and ulna. The main upper extremity dislocation is located to the glenohumeral articulation (41%) for skiing and to the elbow (48%) for snowboarding. Comparing alpine ski to snowboard, it can be noticed that hand injuries are significantly more prevalent while skiing, but the rest of upper extremity injuries are significantly more prevalent while snowboarding. The comparison between alpine ski and telemark did not show any significant difference. For skiing, the time trends from the year 2000’s on have shown a significant increase in fractures for all segments, shoulder girdle dislocations and hand sprains. The snowboard’s epidemiology did not show any significant change in the last two decades, besides an increase in elbow fractures. Conclusion: About 1 injury out of 4 for alpine ski and 1 injury out of 3 for snowboard is located to the upper extremity. The epidemiology varies significantly between skiing and snowboarding, with generally a higher prevalence in snowboarding. The time trends show that carving increased the incidence of upper extremity fracture, which can be explained by higher kinetics, bigger edge angle and the democratization of the sport. The lack of change in the snowboard’s epidemiology could be explained by the absence of significant technical modification in the material.