Ski fractures above or below the boot top.

In a group of 643 skiers with fractures of the tibial shaft there were 161 ski boot fractures. The authors identified and classified these fractures according to the amount of instability, comminution, angulation, displacement, rotational deformity and ankle joint involvement. The majority of less severe fractures occurred in children and adolescents while the number of more severe fractures increased in proportion to the skier's age. Seventy-two skiers were included in the follow-up examination. Closed management of ski boot fractures offered satisfactory results. Type 3 and 4 fractures (unstable, comminuted, with angulation greater than 15 degrees, displacement and rotational deformity) sometimes resulted in osteoarthritis of the ankle joint. The authors present a biomechanical explanation of deformity through a quasistatic force analysis of the observed fracture level.