Division of Sports Medicine, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA 94063, USA.
Br J Sports Med. 2009 Dec;43(13):987-92. doi: 10.1136/bjsm.2009.068767.
There has been a decrease in the overall injury rate, particularly the rate of lower-extremity injuries, for alpine skiing, with a resultant increase in the ratio of upper-extremity to lower-extremity injuries. The upper extremity is injured nearly twice as often during snowboarding than alpine skiing, with approximately half of all snowboarding injuries involving the upper extremity. Shoulder injuries are likely under-reported, as many patients seek evaluation for minor shoulder injuries with their local physicians, and not at the ski medical clinic, where most epidemiology studies obtain their data. Shoulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper-extremity injuries. During snowboarding, shoulder injuries account for 8 to 16% of all injuries and 20 to 34% of upper-extremity injuries. Falls are the most common mechanism of shoulder injury, in addition to pole planting during skiing and aerial manoeuvres during snowboarding. Common shoulder injuries during skiing and snowboarding are rotator cuff strains, glenohumeral dislocations, acromioclavicular separations and clavicle fractures. It is still unclear, when comparing snowboarding and skiing injury data, which sport has the higher incidence of shoulder injuries. Stratifying shoulder injuries by type allows better delineation as to which sport has an increased incidence of certain injury patterns. The differing mechanisms of injury combined with distinct equipment for each sport plays a role in the type and frequency of shoulder injuries seen in these two subgroups. With the increased ratio of upper- to lower-extremity injuries during alpine skiing and the boom in popularity of snowboarding, shoulder injuries are seen with increasing frequency by those who care for alpine sport injuries. According to recent epidemiological data, only clavicle and humerus fractures have shown increased rates of incidence among alpine skiers. Over the past 30 years, there has been a general decrease in both upper- and lower-extremity injuries which can be attributed to improved designs of protective equipment, increased awareness of injury patterns and emphasis on prevention. In the future, physicians and therapists who treat this population must be comfortable and confident in their treatment algorithms to help keep skiers and snowboarders conditioned and ready for the slopes and develop strategies for the prevention of upper-extremity injuries associated with these activities.
总的受伤率，尤其是下肢受伤率有所下降，导致上肢与下肢受伤的比例增加。与高山滑雪相比，单板滑雪上肢受伤的几率几乎高出两倍，大约一半的单板滑雪受伤都涉及上肢。肩部受伤可能被低估了，因为许多患者因轻微肩部受伤在当地医生处就诊，而不是在滑雪医学诊所就诊，而大多数流行病学研究都是从那里获取数据的。肩部受伤占高山滑雪受伤的 4%至 11%，占上肢受伤的 22%至 41%。在单板滑雪中，肩部受伤占所有受伤的 8%至 16%，占上肢受伤的 20%至 34%。除了滑雪时的撑杆和单板滑雪时的空中动作外，摔倒也是肩部受伤的最常见机制。滑雪和单板滑雪时常见的肩部损伤包括肩袖拉伤、盂肱关节脱位、肩锁关节分离和锁骨骨折。当比较单板滑雪和高山滑雪的受伤数据时，哪种运动的肩部受伤发生率更高仍不清楚。通过损伤类型对肩部损伤进行分层，可以更好地区分哪种运动的某些损伤模式发生率更高。不同的受伤机制加上每种运动的独特设备，在这两个亚组中肩部受伤的类型和频率中都发挥了作用。随着高山滑雪中上肢与下肢受伤比例的增加以及单板滑雪的普及，照顾高山运动损伤的人越来越频繁地看到肩部受伤。根据最近的流行病学数据，只有锁骨和肱骨骨折在高山滑雪者中的发病率有所增加。在过去的 30 年中，上肢和下肢受伤的总体发生率都有所下降，这可以归因于防护设备设计的改进、对受伤模式的认识提高以及对预防的重视。在未来，治疗这一人群的医生和治疗师必须对他们的治疗方案有信心，以帮助滑雪者和单板滑雪者保持良好的状态，为滑雪做好准备，并制定预防与这些活动相关的上肢受伤的策略。
