shoulder dislocations in snow sports. epidemiology

Shoulder dislocations in Shoulder dislocations in snow sports. Epidemiologysnow sports. Epidemiology

Escoda Alegret B (1), Gonzalez Casallo J (2), Castro Digon I (1), Escoda Alegret B (1), Gonzalez Casallo J (2), Castro Digon I (1), Guirro Castellnou P (1), Ruiz Edo N (1), Pereira Brito D (1), Guirro Castellnou P (1), Ruiz Edo N (1), Pereira Brito D (1), Gonzalez Carranza S (1), Alduncin I (1), Escoda Alegret A Gonzalez Carranza S (1), Alduncin I (1), Escoda Alegret A (1), Dr Escoda Sales JM (1)(1), Dr Escoda Sales JM (1)

Centre Mèdic Pas de la Casa- Grau Roig, AndorraCentre Mèdic Pas de la Casa- Grau Roig, Andorra

Hamilton Investigacio, AndorraHamilton Investigacio, Andorra

[email protected]@andornet.ad

GLENO HUMERAL GLENO HUMERAL LUXATIONLUXATION

- painful injury- painful injury

- neurovascular complications - neurovascular complications

- lesions of the soft tissues- lesions of the soft tissues

- Quick reduction is possible and - Quick reduction is possible and preferable to time wasting preferable to time wasting

transportation and reduction under transportation and reduction under general anesthesiageneral anesthesia

- This injury is not the most - This injury is not the most common in snow sports but it is common in snow sports but it is quite typical, seen both in skiers quite typical, seen both in skiers and snowboarders and present and snowboarders and present along the historical evolution of along the historical evolution of

this sports.this sports.-The quick pain relieving, the -The quick pain relieving, the

complications saved by our action complications saved by our action confirm the important role of the confirm the important role of the

ski resort doctor.ski resort doctor.



- We analized data concerning injured We analized data concerning injured skiers/snowboarders seen in the medical centers of Pas skiers/snowboarders seen in the medical centers of Pas de la Casa and Grau Roig in Grandvalira, ANDORRA, de la Casa and Grau Roig in Grandvalira, ANDORRA, the largest ski area in the Pyrénéesthe largest ski area in the Pyrénées

- 8 SEASONS 8 SEASONS 33096 INJURIES (MEAN 4137/SEASON)33096 INJURIES (MEAN 4137/SEASON)


TOTAL INJURIES

010002000300040005000

2001

/200

2

2002

/200

3

2003

/200

4

2004

/200

5

2005

/200

6

2006

/200

7

2007

/200

8

2008

/200

9

SEASON

NU

MB

ER

OF

IN

JU

RIE

S

TOTAL INJURIES

MEAN


TOTAL INJURIES PTSD

0

1

2

3

4

5

6

7

2001

/200

2

2002

/200

3

2003

/200

4

2004

/200

5

2005

/200

6

2006

/200

7

2007

/200

8

2008

/200

9

SEASON

INJ

PE

R 1

00

0 S

KIE

R D

AY

INJ X 1000 SKIERDAY

MEAN


% OVER TOTAL INJURIES

10

3

87

OTHER SHOULDERINJURIES

SHOULDER LUXATION

OTHER INJURIES


INJURIES OF THE SHOULDER REGION

0

24

6

8

1012

14

16

2001

/200

2

2002

/200

3

2003

/200

4

2004

/200

5

2005

/200

6

2006

/200

7

2007

/200

8

2008

/200

9

SEASON

% O

VE

R T

OT

AL

INJU

RIE

S

SHOULDERINJUR (% total)

MEAN

INJURIES OF THE SHOULDER PTSD

00,10,20,30,40,50,60,70,80,9

1

2001/2

002

2002/2

003

2003/2

004

2004/2

005

2005/2

006

2006/2

007

2007/2

008

2008/2

009

SEASONP

TS

D Les CE (x1000 SD)

MEAN


SHOULDER LUXATIONS

0

0,5

1

1,5

2

2,5

3

3,5

2001

/200

2

2002

/200

3

2003

/200

4

2004

/200

5

2005

/200

6

2006

/200

7

2007

/200

8

2008

/200

9

SEASON

% O

VE

R T

OT

AL

INJU

RIE

S

SHOULDER LUX(% total)

MEAN

SHOULDER LUXATION

00,020,040,060,08

0,10,120,140,160,18

2001

/200

2

2002

/200

3

2003

/200

4

2004

/200

5

2005

/200

6

2006

/200

7

2007

/200

8

2008

/200

9

SEASONP

TS

D Lux (x1000 SD)

MEAN


ACUMULATED SNOW

0200400600800

2001

/20 0220

02/20 03

2003

/20 0420

04/20 05

2005

/20 0620

06/20 07

2007

/20 0820

08/20 09

SEASON

SNOW

CM Serie1


IN PATIENTS WITH ANAMNESIS IN PATIENTS WITH ANAMNESIS SUGGESTING SHOULDER DISLOCATIONSUGGESTING SHOULDER DISLOCATION::SUPPOSED DISLOCATION IS SUPPOSED DISLOCATION IS SPONTANEOUSLY REDUCED IN 15% OF SPONTANEOUSLY REDUCED IN 15% OF THE CASES (SOME DURING UNDRESSING)THE CASES (SOME DURING UNDRESSING)REDUCTION NEEDED IN 85% OF THE REDUCTION NEEDED IN 85% OF THE CASESCASES


WHEN REDUCTION IS NEEDED:WHEN REDUCTION IS NEEDED:

98% SUCCESFULL IN THE RESORT 98% SUCCESFULL IN THE RESORT MEDICAL CENTERMEDICAL CENTER

2% UNSUCCESSFULL 2% UNSUCCESSFULL TRANSPORTED TO THE HOSPITALTRANSPORTED TO THE HOSPITAL


ASSOCIATED FRACTURE:ASSOCIATED FRACTURE:

84% OF THE CASES : ONLY 84% OF THE CASES : ONLY GLENO HUMERAL DISLOCATIONGLENO HUMERAL DISLOCATION

16% ASSOCIATED FRACTURE16% ASSOCIATED FRACTURE


SHOULDER LUXATION: GENDER

Female22%

Male78%

CONTROL GROUP

Female40%

Male60%

Men are over represented in shoulder luxation


AVERAGE AGE

31 33,7941

0

10

20

30

40

50

MALE ALL FEMALE

Female sustaining shoulder luxation are 10 years older than male


SHOULDER LUXATION: AGE

< 170%

18-2518%

26-3554%

36-458%

>4520%

CONTROL GROUP: AGE

< 1715%

18-2525%

26-3530%

36-4520%

>4510%

< 17

18-25

26-35

36-45

>45

Over risc for 2 groups:- Aged 26 to 35- aged more than 45


FRACTURE IN OLDER THAN 45

associated fracture

25%

without fracture

75%

FRACTURE IN ALL AGE GROUPS

associated fracture

17%

without fracture

83%

As we could imagine associated fractures are more comon in the older group


SHOULDER REGION INJURIES: MECHANISM

10,513,3

0

5

10

15

COLISION CASUAL FALLING

% O

VER

ALL

IN

JUR

IES

SHOULDER LUXATION: MECHANISM

1,8

3,2

0

1

2

3

4

COLISION CASUAL FALLING% O

VER

ALL

INJU

RIE

S

The most comon cause of shoulder dislocation is casual falling


SKI VS SNOWBOARD

00,10,2

0,30,4

SKI SNOWBOARD

IPTSD

shoulder injuriesPTSD

shoulder luxationPTSD

MEDECINS DE MONTAGNE 2008/2009


DISCUSSION:DISCUSSION:- Shoulder luxation is seen either on skiers and Shoulder luxation is seen either on skiers and

snowboarders with a similar ratesnowboarders with a similar rate- It is more frequent in males than femalesIt is more frequent in males than females- Women sustaining shoulder luxations are older than Women sustaining shoulder luxations are older than

menmen- It is an adult injuryIt is an adult injury- Associated fractures are more frequent in elder Associated fractures are more frequent in elder

peoplepeople


DISCUSSION:DISCUSSION:- Casual falling is the most frequent Casual falling is the most frequent

cause, while other shoulder injuries cause, while other shoulder injuries can be caused either by casuaal can be caused either by casuaal falls or collisions.falls or collisions.


DISCUSSION:DISCUSSION:

Variations in the rate of shoulder luxations Variations in the rate of shoulder luxations are not evident to explain:are not evident to explain:

- quality of the snow is maybe involved but it is quality of the snow is maybe involved but it is dificult to definedificult to define

- variations in other injuries rates are maybe variations in other injuries rates are maybe another explanationanother explanation


CONCLUSION: CONCLUSION: We know some facts about shoulder We know some facts about shoulder

dislocations, but there are still some dislocations, but there are still some unknown issues.unknown issues.

There are lots of data to analyse and There are lots of data to analyse and criticize and maybe find ideas to prevent criticize and maybe find ideas to prevent shoulder luxations.shoulder luxations.

THANK YOU!!!!!THANK YOU!!!!!

[email protected]@andornet.ad

shoulder dislocations in snow sports. epidemiology

Sports

shoulder ptsd

total mean shoulder

total mean injuries

injuries mean33096 injuries

shoulder region

overtotalinjuries shoulder

quick reduction

casa grau roig