Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada; Orthopaedic and Injury Biomechanics Group, University of British Columbia, Vancouver, Canada; School of Biomedical Engineering, University of British Columbia, Vancouver, Canada.
Department of Emergency Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Clin Biomech (Bristol). 2020 Mar;73:122-129. doi: 10.1016/j.clinbiomech.2020.01.011. Epub 2020 Jan 16.
Head injury occurs in up to 47% of skiing or snowboarding injuries and is the predominant cause of death in these sports. In most existing literature reporting injury type and prevalence, head injury mechanisms are underreported. Thus, protective equipment design relies on safety evaluation test protocols that are likely oversimplified. This study aims to characterize severity and mechanism of head injuries suffered while skiing and snowboarding in a form appropriate to supplement existing helmet evaluation methods.
A 6-year, multicentre, retrospective clinical record review used emergency databases from two major trauma centres and Coroner's reports to identify relevant cases which indicated head impact. Records were investigated to understand the relationships between helmet use, injury type and severity, and injury mechanism. Descriptive statistics and odds ratios aided interpretation of the data.
The snow sport head injury database included 766 cases. "Simple fall", "jump impact" and "impact with object" were the most common injury mechanisms while concussion was observed to be the most common injury type. Compared to "edge catch", moderate or serious head injury was more common for "fall from height" (OR = 4.69; 95% CI = 1.44-16.23; P = 0.05), "jump impact" (OR = 3.18; 95% CI = 1.48-7.26; P = 0.01) and "impact with object" (OR = 2.44; 95% CI = 1.14-5.56; P = 0.05). Occipital head impact was associated with increased odds of concussion (OR = 7.46; 95% CI = 4.55-12.56; P = 0.001).
Snow sport head injury mechanisms are complex and cannot be represented through a single impact scenario. By relating clinical data to injury mechanism, improved evaluation methods for protective measures and ultimately better protection can be achieved.
头部损伤在滑雪或单板滑雪损伤中发生率高达 47%，是这些运动的主要致死原因。在大多数现有的报告损伤类型和流行率的文献中，头部损伤机制的报告不足。因此，防护设备的设计依赖于安全评估测试协议，这些协议可能过于简化。本研究旨在以适合补充现有头盔评估方法的形式描述滑雪和单板滑雪时头部损伤的严重程度和机制。
一项为期 6 年的多中心回顾性临床病历研究，使用来自两个主要创伤中心的紧急数据库和验尸官报告，以确定表明头部撞击的相关病例。对记录进行调查，以了解头盔使用、损伤类型和严重程度以及损伤机制之间的关系。描述性统计和优势比有助于解释数据。
雪地运动头部损伤数据库包括 766 例病例。“简单摔倒”、“跳跃撞击”和“与物体撞击”是最常见的损伤机制，而脑震荡是最常见的损伤类型。与“边缘捕捉”相比，“从高处坠落”（OR=4.69；95%CI=1.44-16.23；P=0.05）、“跳跃撞击”（OR=3.18；95%CI=1.48-7.26；P=0.01）和“与物体撞击”（OR=2.44；95%CI=1.14-5.56；P=0.05）更常见中度或严重的头部损伤。枕部头部撞击与脑震荡的发生几率增加相关（OR=7.46；95%CI=4.55-12.56；P=0.001）。
雪地运动头部损伤机制复杂，不能用单一的撞击情况来表示。通过将临床数据与损伤机制相关联，可以实现对防护措施的改进评估方法，并最终实现更好的保护。
