Injuries to individuals participating in mountain and wilderness sports: a review.

OBJECTIVE

The objective of this review is to summarize evidence on injuries occurring in individuals participating in mountain and wilderness sports.

DATA SOURCES

Scopus, ISI Web of Knowledge, SPORTDiscus, Ovid Safety and Health, Index to Theses, COPAC, and sportscotland e-library. The search terms were (mountain* or wilderness or adventure or climb* or (hill walk*)) and (accident* or injur* or rescue*) and (epidemiolog* or statistic* or pattern* or survey*). The search period was from 1987 to 2010.

STUDY SELECTION

A total of 2034 articles were identified. The full text of 137 articles was retrieved. Fifty articles met inclusion criteria-mountain and wilderness; nonmotorized, leisure time, outdoor activities; and nonfatal injury. Skiing and snowboarding articles were excluded.

DATA EXTRACTION

Study design was classified using the "STOX" hierarchy of evidence. Study quality was rated independently by 2 reviewers.

DATA SYNTHESIS

All studies were observational. Twenty-one (42%) were longitudinal, 20 (40%) were cross-sectional surveys, and 9 were cohort studies. A majority of casualties were aged 20 to 39 years. There was a clear male majority, 70% to 89% in most studies. The percentage of casualties who sustained severe injuries ranged from 5% to 10%--less than 10% were admitted to hospital. Casualties sustained an average of 1.2 to 2.8 injuries (most >1.6), which mainly affected the soft tissues; between 2% and 38% were fractures. Up to 90% of injuries were to the extremities.

CONCLUSIONS

The majority of mountain and wilderness sports injuries are minor to moderate. However, some casualties have life-threatening medical problems, which may have long-term implications for return to sport and general well-being.