ski injury trauma gallery original pictures

8/14/2019 Ski Injury Trauma Gallery Original Pictures

1/12

Ski Trauma in Australia 1953-1990

Eugene Sherry MD FRACS

Introduction:

People are surprised to hear that you can snow ski in Australia.

In fact Australia has a snow covered area bigger than Europe. Of course the

Snow is thinner than that in the US or Europe, but at least here you can ski

In the sun (in bikinis or shorts-the ULTIMATE experience). There are few avalanches.

I collected this data on the 10,000 injuries I personally treated 1983-86(incl)

In Perisher Valley, NSW (E.Sherry et al.Trends in skiing injury type and rates in Australia.

A review of 22,261 injuries over 27 years in the Snowy Mountains.

Med J Aust. 1991 Oct 21; 155(8):513-5)

(all this material is copyright).

History of sport

CPR on the slopes Types of injuries Perisher Valley (PV), NSW

Development of skis Dev. of boots, soft Dr John Shedden, first to

from strap in to leather to firm hold collect stats in NSW

Binding release.


2/12



(

I collected Risk factors Location Over view

data on > 20,000

injuries ( 1983-86).

Background;

A prospective study of 1850 skiing injuries which occurred during the 1983 skiing season in

Australia, all injuries were seen and treated by the same medical practitioner, showed upper

extremity injuries and lower extremity injuries were almost equally represented (36% and 42% of

the total number of injuries, respectively); injuries to the head, face and neck accounted for 17% of

the total number of injuries. The injury rate of 3.80 per 1000 skiers establishes skiing as a safe sport.Attention is drawn to the high incidence of facial lacerations and of disruption of the ulnar collateral

ligament of the metacarpophalangeal joint of the thumb ("skier's thumb"). It is recommended that

both competitive and recreational skiers wear helmets with attached visors. With adequate medical

personnel and facilities, over 90% of injuries can receive definitive primary treatment on location;

this results in minimum patient discomfort, complications. And hospital costs. (E Sherry. Skiing

injuries in Australia.Med J Aust. 1984 Apr 28; 140(9):530-1).

The trends in the rate and type of skiing injuries in Australia.

A retrospective analysis. Skiing injuries in the Snowy Mountains, NSW, from 1962 to 1988.

All injuries were seen and treated at the Ski Injury Clinic in Perisher Valley.

A total of 22,261 injuries were seen over this 27 year period (data for 1963, 1964, 1966, 1977, 1978, 1981 and 1982

were missing).

Injured skiers were treated at the Clinic with a small number sent to main centres for tertiary care.

The overall injury rate (1962-1988) and the specific injury rate for six subgroups of injuries (1974-1988) werecalculated.

The overall injury rate declined dramatically over this period.

The incidence of tibial fractures, ankle injuries and lacerations also declined. Upper body injuries continue to rise

although this trend was not statistically significant.

There was a statistically significant increase in knee injuries.

The trends reported here are similar to those overseas except that the incidence of thumb injuries has not

changed in Australia. The changes in the rates of lacerations, and tibial and ankle injuries can be related to

improvements in ski bindings and boots.


3/12



PV on a busy Injury trending down Changing types of injuries

Weekend, 20,000

Skiers on slopes

Lower limb injuries Injury rate

X- country lower rate Because more isolated

but more severe.

Nordic Injuries:

A retrospective study of 88 nordic skiing injuries from the 1984 and 1985 skiing seasons in Australia is presented. To

our knowledge, this is the largest study to date of such injuries. These injuries are compared with alpine skiing injuries

from the same medical clinic for the 1985 skiing season.

There was a much lower incidence of injury from nordic skiing; however, when injuries did occur, they tended

to be more serious than those of alpine skiing and frequently required immediate evacuation to hospital for

treatment.

As the nordic skier is relatively isolated from medical services, these findings need to be considered in the future

planning of rescue services for such skiers.

(E Sherry et al.Hazards of cross country skiing. Aust Fam Physician. 1987 Jun; 16(6):851); E Sherry et al.

Nordic (cross-country) skiing injuries in Australia. Med J Aust. 1987 Mar 2; 146(5):245-6).


4/12



Norwegian gold miners Postman Poling on skis Skiing from antiquity

on skis first to ski here

Helicopter down Slope preparation- very important to prevent injuries

SHL dislocations common Also A/C jnt injuries

Beware- lunate dislocation


5/12



Fx femur, use MAST suit Dislocation knee (easy to reduce);

Disloc. Hip (hard to reduce)

(E Sherry. Complete dislocation of the knee.

Med J Aust.1985 May 13; 142(10):577).

Post hip disloc. Ankle Fx., common Fib Fx at top of boot Ankle held

In old or loose boots. firmly in

new boots.

Blood at tip penis= pelvic Fx Knee injuries- common

(ruptured urethra)

Fx femoral shaft Open Fx tibia


6/12



Tibial Fx- 2 types: spiral & transverse (boot-top).

Subtalar dislocation

Splint lig. Skiers tb, bony

Skiers tb avl UCL/MCP,

UCL/MCP related to ski poles

Arm Fx.s Fx humerus. Easy to miss Scaphoid Fx


7/12



Lacerations common from

Ski edges (razor sharp)

Of the tongue, Of the lip Of the ear

Ski stock into (van Gogh injury)

Skiers mouth.

Of the scrotum Easily fixed

(Other case: E Sherry et al. Torsion of the testis in a skier.

Med J Aust. 1986 Mar 17; 144(6):332-3).

Arms Of the scalp

(Crucifixion (exclude skull Fx)

Injury)


8/12



Death in the afternoon: One avalanche (1953)One death per one million skier days

(E Sherry et al. Deaths associated with skiing in Australia: a 32-year study of cases from the Snowy

Mountains. Med J Aust. 1988 Dec 5-19; 149(11-12):615-8)

Trauma:Mainly Head Injuries

Broken Neck, fall, x-country, 24yo, male

Death from Skiing:

The first study of skiing-related deaths in Australia--a 32-year study of skiing-related deaths in the Snowy

Mountains.

We report 29 such cases;

eight subjects died of TRAUMA,

15 subjects died of CARDIOVASCULAR CAUSES,

and six subjects died of HYPOTHERMIA.

The over-all incidence of death = 0.87 deaths per million skier-days;

-Trauma-related deaths was 0.24 deaths per million skier-days;

-Cardiac-related deaths was 0.45 deaths per million skier-days;

-Hypothermia-related deaths was 0.18 deaths per million skier-days.

These findings compare most-favourably with US figures.


9/12



Mainly heart attacks, Hard to resuscitate Aussies dont understand the cold;

in the cold. new-comers often turn up in shorts and thongs

In sun, snows melts # ribs, pneumo-thorax

Quickly, exposing dangerous terrain

Hypothermia:

Even in relatively temperate environments, accidental hypothermia is a potentially lethal complication

of exposure. We have reviewed our experience of accidental hypothermia among recreational alpine

skiers at an Australian resort during the 1983 and 1984 seasons.

There were 19 cases of accidental hypothermia, which occurred in 10 men and nine women who were

aged between six and 47 years (mean age, 15.9 years) and who had rectal temperatures that ranged

from less than 35 degrees C to 36 degrees C.

The temperature at presentation to the Ski Injury Clinic was less than 35 degrees C in seven cases.

One patient presented to the Clinic with a gastrointestinal haemorrhage in addition to hypothermia,

and one was initially thought to be suffering from alcohol intoxication. Two patients were lost in the

snow overnight. All patients were removed from the snow, changed into warm dry clothes where

necessary, and their body temperatures allowed to return to normal spontaneously (17 patients), or

were exposed to heat actively by means of inhaled, heated, humidified air (two severely obtunded

patients). All patients responded satisfactorily.

There were no deaths and no sequelae. We conclude that all skiers should be advised to wear effective

thermal insulation, and to ski with a partner to ensure that adequate care is taken to prevent

accidental hypothermia. Inhalational "warming" is effective in the treatment of hypothermia in

obtunded patients.

(E Sherry et al. Hypothermia among resort skiers: 19 cases from the Snowy Mountains. Med J Aust.

1986 A r 28 144 9 :457-61 .


10/12



Near misses, use of much more likely to die in MVAs

alcohol and drugs, in-experience around resorts.

( Aussies brought up on

Surf board NOT skis)

#1. 17yo M, never skied before, drunk, smoked joint, no lessons, steep slope, Fx skull, residual

hemiplegia.

#2. 33yo M, doctor-country skied alone, facial injuries and fractures, happened to be found by ski rescue

group on an exercise.

Childrens Fx. More serious, should wear helmets.

Childrens Skiing Injuries:

Skiing is one of the most popular winter sports for adults and children in Australia. While much is

known about the epidemiology of skiing trauma in adults, little has been written about the patterns

of skiing injury in children in Australia. During the 1984 ski season, the injuries and risk factors of

149 children were compared with those of 1093 adults who were injured over the same period.

Although Australian children were found to be possibly less prone to injury than were adults, they

did sustain more serious injuries, in particular, fractures of the tibia.

The significantly different associated risk factors that are thought to be responsible were the

greater number of children who were injured in collisions and ski-lift accidents, and inadequate

bindings on their skis. Such shortcomings are correctable; children require better boot-bindings

and greater supervision on the ski-slopes.

(Children's skiing injuries in Australia. Med J Aust. 1987 Feb 16; 146(4):193-5).


11/12



ALL TREATED: Apply paddle pop to leg

Kookaburra, broken leg

The Future New wave: snow boarding

Medical Olympic Games

In Snow

Miscell:

(E Sherry.Medical problems in skiers.

Med J Aust. 1985 Jul 22; 143(2):92)

S/C Fx lower femur Ski tube tunnel on fire prior to season

Bad sunburn All sorts of medical and surgical

( excl. sunstroke) problems( strangulated haemorrhoids)


12/12

ski injury trauma gallery original pictures

Documents