E2125. Wipeout: A Review of Fractures Associated with Skiing and Snowboarding
  1. Nathaniel Mizraki; Cedars-Sinai Medical Center
  2. Joseph Giaconi; Cedars-Sinai Medical Center
Skiing and snowboarding are popular activities with an inherent risk of injury, and as snowsports increase in popularity, the prevalence of injury increases in kind. Skiing and snowboarding have fracture patterns which are unique to each sport, as result from differing mechanisms of injury. Familiarity with these unique fractures is highly valuable in the emergency radiology setting.

Educational Goals / Teaching Points
The primary educational goal of this exhibit will be to review the unique fracture patterns that occur with skiing versus snowboarding, with an emphasis on mechanism of injury, risk factors, and associated injuries. The prevalence of snowsport injuries will be highlighted with epidemiological data. Finally, focus will be placed on the value of recognizing these fractures in the emergency radiology setting.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Alpine skiing is most likely to result in injuries of the lower extremity, most commonly of the proximal tibial shaft. Tibial plateau fractures are becoming more common with the increasing age of skiers. Distal tibial shaft fractures are seen in the pediatric population. Segond fractures are highly associated with anterior cruciate ligament (ACL) injury, the most common soft tissue injury sustained while skiing. Upper extremity fractures include “Skier’s thumb”, an avulsion fracture which occurs from forced hyperextension, as occurs from a fall while holding a ski pole, as well as midclavicular shaft fractures. On the other hand, snowboarding is highly associated with fractures of the upper extremity, particularly of the distal radius. These fractures result from a fall on an outstretched hand and may have dorsal or volar angulation depending upon the exact mechanism of injury. Scaphoid fractures can also occur and may be extremely subtle on initial radiographs. In the lower extremity, fractures of the lateral talar process are also known as a “snowboarder’s fracture”, and result from foot dorsiflexion and inversion, as can occur during a fall while the foot is strapped to the snowboard.

Skiing and snowboarding are popular winter activities that carry an inherent risk of injury, and unique fracture patterns are seen with each sport. Skiing is more likely to result in lower extremity fractures, whereas snowboarding is more likely to result in upper extremity fractures, although there are specific exceptions to this trend. Familiarity with these fracture patterns can aid diagnosis, expedite patient care, and prevent unnecessary imaging.