滑雪者胫骨前棘骨折的发生率与年龄无关。
Incidence of anterior tibial spine fracture among skiers does not differ with age.
机构信息
Department of Orthopaedics and Rehabilitation, University of New Mexico Health Sciences Center, MSC10 5600, 1, Albuquerque, NM, 87131-0001, USA.
Department of Orthopaedics and Rehabilitation, University of Vermont Medical Center, Burlington, VT, USA.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2022 Jul;30(7):2291-2297. doi: 10.1007/s00167-021-06782-7. Epub 2021 Nov 20.
PURPOSE
Injury to the anterior cruciate ligament (ACL) is common in alpine skiing in the form of either an intra-substance ACL tear or anterior tibial spine fracture (ATSF). Anterior tibial spine fractures are typically reported in children. However, several case reports describe these injuries in adults while skiing. The purpose of this study is to describe the sport specific incidence of ATSF in alpine skiing.
METHODS
The study was conducted over a 22-year period. Skiers who suffered an ATSF were identified and radiographs were reviewed to confirm the diagnosis. Additionally, control data from intra-substance ACL injury groups were collected. The incidence of these injuries in children, adolescents, and adults (grouped as ages 0-10, 11-16, and 17 + years old, respectively) was evaluated and the risk factors for ATSF versus ACL tear were determined.
RESULTS
There were 1688 intra-substance ACL and 51 ATSF injuries. The incidence of intra-substance ACL injury was greater in adults (40.0 per 100,000 skier days) compared to the adolescent (15.4 per 100,000) and child (1.1 per 100,000) age groups. In contrast, the incidence of ATSF was similar in the adult (0.9 per 100,000), adolescent (1.9 per 100,000), and child (1.9 per 100,000) age groups. Loose ski boot fit was identified as a risk factor for ATSF.
CONCLUSION
The incidence of ATSF in alpine skiers is similar among all age groups. However, the incidence of intra-substance ACL injuries is far greater in adult skiers compared to adolescents and children. Risk factors for ATSF relate to compliance between the foot/ankle and the ski boot.
LEVEL OF EVIDENCE
III.
目的
前交叉韧带（ACL）损伤在高山滑雪中较为常见，表现为 ACL 内部分撕裂或胫骨前嵴骨折（ATSF）。胫骨前嵴骨折通常发生于儿童，但也有一些病例报告描述了成年人在滑雪时出现此类损伤。本研究旨在描述高山滑雪中 ATSF 的特定运动损伤发生率。
方法
本研究进行了 22 年。确定发生 ATSF 的滑雪者，并对其进行 X 线检查以确认诊断。此外，还收集了 ACL 内部分撕裂损伤组的对照数据。评估这些损伤在儿童、青少年和成年人（分别归类为 0-10 岁、11-16 岁和 17 岁及以上年龄组）中的发生率，并确定 ATSF 与 ACL 撕裂的危险因素。
结果
共发生 1688 例 ACL 内部分撕裂和 51 例 ATSF 损伤。成人（40.0 例/10 万滑雪者天）ACL 内部分撕裂损伤的发生率高于青少年（15.4 例/10 万）和儿童（1.1 例/10 万）。相比之下，成人（0.9 例/10 万）、青少年（1.9 例/10 万）和儿童（1.9 例/10 万）ATSF 损伤的发生率相似。滑雪靴不合脚被确定为 ATSF 的危险因素。
结论
高山滑雪运动员 ATSF 的发生率在所有年龄段相似。然而，与青少年和儿童相比，成年滑雪者 ACL 内部分撕裂损伤的发生率要高得多。ATSF 的危险因素与足踝和滑雪靴之间的贴合度有关。
证据等级
III 级。
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