Pätzold R, Spiegl U, Wurster M, Augat P, Gutsfeld P, Gonschorek O, Bühren V
BG Unfallklinik Murnau.
Abteilung für Unfall- und Rekonstruktionschirurgie, Universität Leipzig.
Sportverletz Sportschaden. 2013 Dec;27(4):207-11. doi: 10.1055/s-0033-1356108. Epub 2013 Dec 18.
Prior to introduction of carving skis, complex fractures of the proximal tibia were rarely seen. Recently these fractures are being seen more frequently in connection with alpine skiing. The aim of this study was to find out the incidence of proximal tibia fractures in alpine skiing and to identify possible risk factors.
All patients with proximal tibia fractures related to alpine skiing in a large German ski resort were included. Fracture type, patient and skiing related factors were recorded. Incidence of fractures was determined by using the number of all registered skiers. Multinomial logistic regression analysis was used to calculate the odds ratios for risk factors.
Between 2007 and 2010 a total of 188 patients was treated for proximal tibia fractures caused by alpine skiing. Forty-three patients had a type-A injury, 96 patients a type-B injury, and 49 patients a type-C injury. The incidence of injury increased continuously, starting from 2.7 and climbing to 7.0 per 10⁵ skiing days. The risk factors compared to patients with type-A fractures, type-C fracture occurred in older (OR 0.93; 0.89 - 0.97) and heavier (OR 0.86; 0.74 - 0.99) individuals and were more likely on icy snow conditions (OR 0.22; 0.05 - 0.96), higher speed (OR 0.29; 0.09 - 0.97) and skiing skill (OR 0.35; 0.13 - 0.95). These was also seen in artificial and icy snow conditions (OR 0.25; 0.07 - 0.87) when compared to type-B fractures.
The incidence of proximal tibia fractures related to skiing has increased over the past four years. Risk factors such as age, BMI, snow conditions, speed, and the skill of the skiers, were identified as causes contributing to complex fractures.
在刻滑滑雪板出现之前，胫骨近端的复杂骨折很少见。最近，这些骨折在高山滑雪中更为频繁地出现。本研究的目的是找出高山滑雪中胫骨近端骨折的发生率，并确定可能的风险因素。
纳入德国一个大型滑雪胜地所有与高山滑雪相关的胫骨近端骨折患者。记录骨折类型、患者及与滑雪相关的因素。通过使用所有注册滑雪者的数量来确定骨折发生率。采用多项逻辑回归分析来计算风险因素的比值比。
2007年至2010年期间，共有188例患者因高山滑雪导致的胫骨近端骨折接受治疗。43例患者为A型损伤，96例患者为B型损伤，49例患者为C型损伤。损伤发生率持续上升，从每10⁵个滑雪日2.7例升至7.0例。与A型骨折患者相比，C型骨折发生在年龄较大（比值比0.93；0.89 - 0.97）和体重较重（比值比0.86；0.74 - 0.99）的个体中，并且在结冰雪况（比值比0.22；0.05 - 0.96）、较高速度（比值比0.29；0.09 - 0.97）和滑雪技能（比值比0.35；0.13 - 0.95）情况下更易发生。与B型骨折相比，在人造雪和结冰雪况下（比值比0.25；0.07 - 0.87）也有类似情况。
在过去四年中，与滑雪相关的胫骨近端骨折发生率有所上升。年龄、体重指数、雪况、速度和滑雪者技能等风险因素被确定为导致复杂骨折的原因。
