Distal Upper Limb Injuries in Skiing and Snowboarding: A Two-Season Study from a High-Volume Trauma Center in the Italian Dolomites
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Questionnaire and Data Collection
2.3. Variable Definitions and Categorization
- Injury type (e.g., fractures, ligamentous injuries)
- Injury location (e.g., forearm, wrist, hand, fingers)
- Environmental context (e.g., slope type, snow conditions, weather)
- Equipment characteristics, and
- Skier demographics
2.4. Statistical Analysis
2.4.1. Fracture vs. Non-Fracture Risk Analysis
2.4.2. Risk Factors for Fracture Severity (Good vs. Bad)
2.4.3. UCL Injury Subgroup Analysis
3. Results
3.1. Fracture vs. Non-Fracture Risk Analysis Results
3.2. Risk Factors for Fracture Severity (Good vs. Bad) Results
3.3. UCL Injury Subgroup Analysis Results
4. Discussion
4.1. Injury Prevalence
4.2. Trauma Mechanism
4.3. Risk Factors
4.4. Preventive Strategies
4.5. Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
AO | Arbeitsgemeinschaft für Osteosynthesefragen |
BMI | Body mass index |
UCL | Ulnar collateral ligament |
ACL | Anterior cruciate ligament |
MCL | Medial collateral ligament |
MCPJ | Metacarpophalangeal joints |
SD | Standard deviation |
n | number |
SABES | Suedtiroler Sanitaetsbetrieb—Azienda Sanitaria dell’ Alto Adige |
Appendix A
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Characteristic | Total (n = 195) |
---|---|
Age, mean ± SD (years) | 40.4 ± 17.7 |
BMI, mean ± SD (kg/m2) | 23.5 ± 3.7 |
Hours of activity/day, mean ± SD | 2.4 ± 1.7 |
Days of activity/season, mean ± SD | 9.1 ± 10.8 |
Sex, n (%) | |
Male | 92 (47.2) |
Female | 103 (52.8) |
Driving skills, n (%) | |
Novice | 42 (21.5) |
Good | 95 (48.7) |
Expert | 52 (26.7) |
Professional athlete | 6 (3.1) |
Characteristic | Total (n = 195) |
---|---|
Slope difficulty, n (%) | |
Blue | 87 (44.6) |
Red | 79 (40.5) |
Black | 19 (9.7) |
Off-piste | 9 (4.6) |
Snowpark | 1 (0.5) |
Snow quality, n (%) | |
Well prepared | 129 (66.2) |
Ice | 28 (14.4) |
Buckle | 27 (13.8) |
Fresh snow | 5 (2.6) |
Off track | 6 (3.1) |
Weather conditions, n (%) | |
Sunny | 135 (69.2) |
Cloudy | 39 (20.0) |
Fog/Poor visibility | 9 (4.6) |
Snow | 12 (6.2) |
Equipment ownership, n (%) | |
Rented | 114 (58.5) |
Owned | 81 (41.5) |
Type of equipment, n (%) [a] | |
Race carver | 46 (23.6) |
All-round/Easy carver | 70 (35.9) |
Slalom carver | 18 (9.2) |
Touring ski | 34 (17.4) |
Twin tip | 4 (2.1) |
Other | 20 (10.3) |
Snowboard | 1 (0.5) |
Characteristic | Total (n = 195) |
---|---|
Cause of accident, n (%) | |
Mistake | 128 (65.6) |
Jump | 13 (6.7) |
Collision | 29 (14.9) |
Cause of matter | 10 (5.1) |
Chairlift | 4 (2.1) |
Fatigue | 11 (5.6) |
Binding release, n (%) | |
Opened | 62 (31.8) |
Not opened | 133 (68.2) |
Injury site, n (%) | |
Arm | 3 (1.5) |
Finger | 26 (13.3) |
Hand | 69 (35.4) |
Wrist | 97 (49.7) |
Injury side, n (%) | |
Left | 97 (49.7) |
Right | 98 (50.3) |
Characteristic | Fracture (n = 96) | Non-Fracture (n = 99) | p-Value |
---|---|---|---|
Total, n | 96 | 99 | |
Age, mean ± SD | 38.7 ± 17.1 | 42.1 ± 18.2 | 0.183 |
BMI, mean ± SD | 23.5 ± 3.6 | 23.5 ± 3.7 | 0.988 |
Hours activity, mean ± SD | 2.2 ± 1.6 | 2.6 ± 1.7 | 0.065 |
Days activity, mean ± SD | 7.9 ± 8.0 | 10.2 ± 12.8 | 0.131 |
Sex, n (%) | 1.000 | ||
– Male | 45 (46.9%) | 47 (47.5%) | |
– Female | 51 (53.1%) | 52 (52.5%) | |
Driving skills, n (%) | 0.090 | ||
– Novice | 27 (28.1%) | 15 (15.2%) | |
– Good | 40 (41.7%) | 55 (55.6%) | |
– Expert | 25 (26.0%) | 27 (27.3%) | |
– Professional athlete | 4 (4.2%) | 2 (2.0%) |
Characteristic | Fracture (n = 96) | Non-Fracture (n = 99) | p-Value |
---|---|---|---|
– Blue | <0.001 | ||
– Red | 54 (56.2) | 33 (33.3) | |
– Black | 30 (31.2) | 49 (49.5) | |
– Off piste | 11 (11.5) | 8 (8.1) | |
– Snowpark | 0 (0.0) | 9 (9.1) | |
Snow quality, n (%) | 1 (1.0) | 0 (0.0) | |
– Well prepared | 0.0654 | ||
– Ice | 64 (66.7) | 65 (65.7) | |
– Buckle | 15 (15.6) | 13 (13.1) | |
– Fresh snow | 16 (16.7) | 11 (11.1) | |
– Snowpark | 1 (1.0) | 4 (4.0) | |
– Off track | 0 (0.0) | 0 (0.0) | |
METEO conditions, n (%) | 0 (0.0) | 6 (6.1) | |
– Sunny | 0.7103 | ||
– Cloudy | 66 (68.8) | 69 (69.7) | |
– Fog/poor visibility | 20 (20.8) | 19 (19.2) | |
– Snow | 3 (3.1) | 6 (6.1) | |
Equipment, n (%) | 7 (7.3) | 5 (5.1) | |
– Rented | 0.7441 | ||
– Owned | 55 (57.3) | 59 (59.6) | |
Type of equipment, n (%) | 41 (42.7) | 40 (40.4) | |
– Race carver | [b] | 0.0637 | |
– All-round/Easy-Carver | 26 (27.1) | 20 (20.2) | |
– Slalom Carver | 29 (30.2) | 41 (41.4) | |
– Toure ski | 7 (7.3) | 11 (11.1) | |
– Twin Tip | 18 (18.8) | 16 (16.2) | |
– Other | 0 (0.0) | 4 (4.0) | |
– Snowboard | 14 (14.6) | 6 (6.1) | |
– Blue | 0 (0.0) | 1 (1.0) |
Characteristic | Fracture (n = 96) | Non-Fracture (n = 99) | p-Value |
---|---|---|---|
Cause, n (%) | 0.5692 | ||
– Mistake | 66 (68.8) | 62 (62.6) | |
– Jump | 6 (6.2) | 7 (7.1) | |
– Collision | 14 (14.6) | 15 (15.2) | |
– Cause of matter | 4 (4.2) | 6 (6.1) | |
– Chairlift | 3 (3.1) | 1 (1.0) | |
– Fatigue | 3 (3.1) | 8 (8.1) | |
– Other | 0 (0.0) | 0 (0.0) | |
Binding open, n (%) | 0.4377 | ||
– Opened | 28 (29.2) | 34 (34.3) | |
– Not Opened | 68 (70.8) | 65 (65.7) | |
Injury site, n (%) | <0.001 | ||
– Arm | 2 (2.1) | 1 (1.0) | |
– Finger | 8 (8.3) | 18 (18.2) | |
– Hand | 20 (20.8) | 49 (49.5) | |
– Wrist | 66 (68.8) | 31 (31.3) | |
Side, n (%) | 0.1612 | ||
– Left | 51 (53.0) | 46 (46.5) | |
– Right | 45 (47.0) | 53 (53.5) |
Characteristic | Good (n = 47) | Bad (n = 16) | p-Value |
---|---|---|---|
Total, n | 47 | 16 | |
Age, mean ± SD (years) | 35.8 ± 17.5 | 40.1 ± 11.7 | 0.269 |
BMI, mean ± SD (kg/m2) | 23.2 ± 3.4 | 23.5 ± 3.1 | 0.783 |
Hours of activity, mean ± SD | 2.3 ± 1.8 | 2.4 ± 1.9 | 0.823 |
Days of activity, mean ± SD | 7.7 ± 9.1 | 6.9 ± 5.1 | 0.689 |
Driving duration, mean ± SD | 13.0 ± 13.1 | 14.8 ± 12.2 | 0.632 |
Sex, n (%) | <0.005 | ||
– Male | 22 (46.8%) | 4 (25.0%) | |
– Female | 25 (53.2%) | 12 (75.0%) | |
Driving skills, n (%) | 0.230 | ||
– Novice | 20 (42.6%) | 3 (18.8%) | |
– Good | 16 (34.0%) | 8 (50.0%) | |
– Expert | 11 (23.4%) | 5 (31.2%) | |
– Professional athlete | 0 (0.0%) | 0 (0.0%) |
Characteristic | Good (n = 47) | Bad (n = 16) | p-Value |
---|---|---|---|
Slope difficulty, n (%) | 0.7521 | ||
– Blue | 29 (61.7%) | 12 (75.0%) | |
– Red | 14 (29.8%) | 3 (18.8%) | |
– Black | 3 (6.4%) | 1 (6.2%) | |
– Off slope | 0 (0.0%) | 0 (0.0%) | |
– Snowpark | 1 (2.1%) | 0 (0.0%) | |
Snow quality, n (%) | 0.6019 | ||
– Well prepared | 30 (63.8%) | 13 (81.2%) | |
– Ice | 4 (8.5%) | 1 (6.2%) | |
– Buckle | 12 (25.5%) | 2 (12.5%) | |
– Fresh snow | 1 (2.1%) | 0 (0.0%) | |
– Snowpark | 0 (0.0%) | 0 (0.0%) | |
– Off track | 0 (0.0%) | 0 (0.0%) | |
METEO conditions, n (%) | 0.9015 | ||
– Sunny | 32 (68.1%) | 11 (68.8%) | |
– Cloudy | 10 (21.3%) | 3 (18.8%) | |
– Fog/poor visibility | 1 (2.1%) | 0 (0.0%) | |
– Snow | 4 (8.5%) | 2 (12.5%) | |
Equipment, n (%) | 0.5141 | ||
– Rented | 25 (53.2%) | 7 (43.8%) | |
– Owned | 22 (46.8%) | 9 (56.2%) | |
Type of equipment, n (%) | 0.5797 | ||
– Race carver | 13 (27.7%) | 4 (25.0%) | |
– All-round/Easy-Carver | 9 (19.1%) | 3 (18.8%) | |
– Slalom Carver | 4 (8.5%) | 1 (6.2%) | |
– Toure ski | 15 (31.9%) | 3 (18.8%) | |
– Twin Tip | 0 (0.0%) | 0 (0.0%) | |
– Other | 6 (12.8%) | 5 (31.2%) | |
– Snowboard | 0 (0.0%) | 0 (0.0%) |
Characteristic | Good (n = 47) | Bad (n = 16) | p-Value |
---|---|---|---|
Cause, n (%) | 0.8518 | ||
– Mistake | 37 (78.7%) | 12 (75.0%) | |
– Jump | 1 (2.1%) | 1 (6.2%) | |
– Collision | 3 (6.4%) | 1 (6.2%) | |
– Cause of matter | 3 (6.4%) | 1 (6.2%) | |
– Chairlift | 1 (2.1%) | 1 (6.2%) | |
– Fatigue | 2 (4.3%) | 0 (0.0%) | |
– Other | 0 (0.0%) | 0 (0.0%) | |
Binding open, n (%) | 0.4795 | ||
– Opened | 13 (27.7%) | 3 (18.8%) | |
– Not Opened | 34 (72.3%) | 13 (81.2%) | |
Type of injury, n (%) | 0.5564 | ||
– Fracture | 47 (100%) | 16 (100.0%) | |
Injury site, n (%) | 0.5564 | ||
– Arm | 1 (2.1%) | 0 (0.0%) | |
– Finger | 0 (0.0%) | 0 (0.0%) | |
– Hand | 0 (0.0%) | 0 (0.0%) | |
– Wrist | 46 (97.9%) | 16 (100.0%) | |
Side of injury, n (%) | 0.6995 | ||
– Left | 26 (55.3%) | 9 (56.2%) | |
– Right | 19 (40.4%) | 7 (43.8%) |
Characteristic | Value | p-Value |
---|---|---|
Total, n | 33 | |
Sex, n (%) | 0.862 | |
– Male | 16 (48.5%) | |
– Female | 17 (51.5%) | |
Age, mean ± SD (years) | 43.2 ± 16.8 | |
BMI, mean ± SD (kg/m2) | 24.1 ± 3.2 | |
Hours of activity, mean ± SD | 2.9 ± 1.7 | |
Days of activity, mean ± SD | 10.1 ± 8.5 | |
Skills level, n (%) | <0.001 | |
– Novice | 3 (9.1%) | |
– Good | 20 (60.6%) | |
– Expert | 10 (30.3%) | |
– Professional athlete | 0 (0.0%) |
Characteristic | Value | p-Value |
---|---|---|
Slope difficulty, n (%) | <0.001 | |
– Blue | 10 (30.3%) | |
– Red | 18 (54.5%) | |
– Black | 3 (9.1%) | |
– Off piste | 2 (6.1%) | |
Snow quality, n (%) | <0.001 | |
– Well prepared | 24 (72.7%) | |
– Ice | 4 (12.1%) | |
– Buckle | 4 (12.1%) | |
– Fresh snow | 1 (3.0%) | |
METEO conditions, n (%) | <0.001 | |
– Sunny | 21 (63.6%) | |
– Cloudy | 8 (24.2%) | |
– Fog/poor visibility | 2 (6.1%) | |
– Snow | 2 (6.1%) | |
Equipment, n (%) | 0.117 | |
– Rented | 21 (63.6%) | |
– Owned | 12 (36.4%) | |
Equipment type, n (%) | <0.001 | |
– All-round | 17 (51.5%) | |
– Race carver | 6 (18.2%) | |
– Slalom Carver | 4 (12.1%) | |
– Toure ski | 4 (12.1%) | |
– Twin Tip | 1 (3.0%) | |
– Other | 1 (3.0%) |
Characteristic | Value | p-Value |
---|---|---|
Cause, n (%) | <0.001 | |
– Mistake | 24 (72.7%) | |
– Jump | 5 (15.2%) | |
– Collision | 1 (3.0%) | |
– Chairlift | 1 (3.0%) | |
– Fatigue | 2 (6.1%) | |
Opening binding, n (%) | 0.117 | |
– Opened | 12 (36.4%) | |
– Not Opened | 21 (63.6%) | |
Site of injury, n (%) | 0.872 | |
– Left | 14 (42.4%) | |
– Right | 19 (57.6%) |
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Share and Cite
Festini Capello, M.P.; Bizzotto, N.; Qordja, F.; Misselwitz, S.; Sernia, C.; Gioitta Iachino, S.; Petralia, G.; van Es, V.A.A.; Indelli, P.F.; Schaller, C. Distal Upper Limb Injuries in Skiing and Snowboarding: A Two-Season Study from a High-Volume Trauma Center in the Italian Dolomites. Medicina 2025, 61, 1787. https://doi.org/10.3390/medicina61101787
Festini Capello MP, Bizzotto N, Qordja F, Misselwitz S, Sernia C, Gioitta Iachino S, Petralia G, van Es VAA, Indelli PF, Schaller C. Distal Upper Limb Injuries in Skiing and Snowboarding: A Two-Season Study from a High-Volume Trauma Center in the Italian Dolomites. Medicina. 2025; 61(10):1787. https://doi.org/10.3390/medicina61101787
Chicago/Turabian StyleFestini Capello, Michele Paolo, Nicola Bizzotto, Fjorela Qordja, Svea Misselwitz, Chiara Sernia, Salvatore Gioitta Iachino, Giuseppe Petralia, Valerie A. A. van Es, Pier Francesco Indelli, and Christian Schaller. 2025. "Distal Upper Limb Injuries in Skiing and Snowboarding: A Two-Season Study from a High-Volume Trauma Center in the Italian Dolomites" Medicina 61, no. 10: 1787. https://doi.org/10.3390/medicina61101787
APA StyleFestini Capello, M. P., Bizzotto, N., Qordja, F., Misselwitz, S., Sernia, C., Gioitta Iachino, S., Petralia, G., van Es, V. A. A., Indelli, P. F., & Schaller, C. (2025). Distal Upper Limb Injuries in Skiing and Snowboarding: A Two-Season Study from a High-Volume Trauma Center in the Italian Dolomites. Medicina, 61(10), 1787. https://doi.org/10.3390/medicina61101787