Shoulder Injuries During Alpine Skiing

We retrospectively reviewed alpine skiing injuries at a destination ski resort during three seasons to charac terize the incidence and types of shoulder injuries. A total of 3451 injuries in 3247 patients were reviewed. The overall injury rate was 4.44 injuries per 1000 skier- days. Injuries to the upper extremity represented 29.1% ( N = 1004) of all alpine ski injuries. Injuries involving the shoulder complex (393 injuries in 350 patients) accounted for 39.1% of upper extremity inju ries and 11.4% of all alpine skiing injuries. The rate of shoulder injury was 0.51 injuries per 1000 skier-days. Patients with shoulder injuries had a mean age of 35.4 years, and the male-to-female ratio of these patients was 3:1. Falls represented the most common mecha nism of shoulder injury (93.9%) in addition to collisions with skiers (2.8%), pole planting (2.3%), and collisions with trees (1%). The most common shoulder injuries were rotator cuff strains (24.2%), anterior glenohu meral dislocations or subluxations (21.6%), acromio clavicular separations (19.6%), and clavicle fractures (10.9%). Less common shoulder injuries included greater tuberosity fractures (6.9%), trapezius muscle strains (6.4%), proximal humeral fractures (3.3%), bi ceps tendon strains (2.3%), glenoid fractures (1.5%), scapular fractures (1%), humeral head fractures (1%), sternoclavicular separations (0.5%), an acromial frac ture (0.3%), a posterior glenohumeral dislocation (0.3%), and a biceps tendon dislocation (0.3%).