Injury patterns at a large Western United States ski resort with and without snowboarders: the Taos experience.

BACKGROUND: Differences in injury patterns among alpine skiers and snowboarders have previously been recognized, and controversy remains about the safety implications that snowboarding may pose to a ski resort. A change of policy at Taos Ski Valley provides a unique and modern perspective on the effect that snowboarders have on ski resort injuries. HYPOTHESIS: The addition of snowboarders to a large ski resort may result in a significant change in both the rate and pattern of injuries treated. STUDY
DESIGN: Descriptive epidemiology study.
METHODS: Patient records from the Mogul Medical Clinic at Taos Ski Valley were reviewed from the 2006-2007 ski season through the 2009-2010 season (approximately 2 years before and after snowboarding was allowed) and recorded for age, sex, diagnosis, body region, anatomic location, injury type, and sport (skiing, snowboarding). The total numbers of mountain visits for the time periods with and without snowboarding were used to determine injury rates.
RESULTS: The overall rate of persons injured increased from 206.7 per 100,000 mountain visits without snowboarders to 233.8 with snowboarders. The relative risk ratio was 1.131, also represented as a 13.1% increased risk of injury (IRI) (statistically significant; 95% CI, 3.5%-23.6%). Increases were seen in the rate of upper extremity injuries (IRI, 39.1%; 95% CI, 14.3-69.4) and head/neck injuries (IRI 30.8%; not significant), while lower extremity and trunk/pelvis injuries remained relatively constant. Distal radius fractures, closed head injuries, and acromioclavicular separations showed statistically significant increases with the addition of snowboarding. The most frequent injuries among snowboarders were distal radius fractures, wrist sprains, closed head injuries, and acromioclavicular separations. The most frequent injuries among skiers were anterior cruciate ligament tears, knee sprains, closed head injuries, and gastrocnemius tears. The median age of injured persons decreased from 39 years (range, 4-100 years) without snowboarders to 31 years (range, 4-99 years) with snowboarders, and this was significant. Approximately 45% of injured persons were female, and this did not change with the addition of snowboarders.
CONCLUSION: In this study, there was a small but statistically significant increase in the likelihood of injury with the addition of snowboarding to a large ski resort. It is likely that factors such as younger demographic, elevated risk-taking behavior, or increased mountain crowding are involved. The difference in injuries is largely because of a significant increase in distal radius fractures, closed head injuries, and acromioclavicular separations. On mountain safety precautions such as widening of runs and streamlining of high traffic areas, training medical providers to recognize and treat sport-specific injuries, and promoting the use of wrist guards and helmets may be useful in reducing the effect that snowboarders have on ski resort injuries.