Helicopter Skiing Wrist Injuries: A Case Report of "Bugaboo Forearm"

Of the 42 skiers, 5 (11.9%) experienced symptoms of intersection syndrome early in their week of powder skiing. According to the mountain guides employed by the helicopter service, this overuse injury is quite common and does not represent an unusual incidence for this group of skiers. The mechanism of injury is likely repetitive dorsiflexion and radial deviation of the wrist against the resistance of deep snow on withdrawal of the planted ski pole. Interestingly, the more advanced competitive alpine skiers appeared to be most at risk, possibly because of their more aggressive pole plants. Preventive measures should include instruction in proper pole technique for powder skiing, avoidance of pole dragging and deep pole plants, and downsizing baskets from the standard 4-inch diameter to 2.5-inches and pole length 2 inches shorter than the recommended length for that skier. Once symptoms occur, switching to a different diameter grip, using the pole strap, nonsteroidal antiinflammatory medications, ice, taping of the thumb and wrist, and night splinting appear to offer some relief. Surgical treatment as described by others. is generally successful for those who fail conservative treatment.