Fracture distribution in alpine skiing – a national population based study of 7,110 fractures in adults and children from the Swedish fracture register

Alpine skiing is practiced with speed and forces which entails a risk of injury and fractures. Most studies focus on all injuries in the musculoskeletal system and fractures are only described briefly or lack comparison between children and adults. This study focuses on the national trends of skiing-related fractures in children and adults, detailing fracture localization characteristics and initial treatments. This is a population-based national cohort study using data from the Swedish Fracture Register. The study population includes children and adults with a fracture sustained by alpine skiing between January 2015 and April 2022. Variables of interest were age, sex, localization of the fracture and segment, the number of fractures per patient, injury date, open or closed fracture, energy level, and primary treatment. In total 7,110 fractures were registered in 6,806 patients. 48.6 % of the fractures were in children The women had a statistically significant higher median age at fracture to men. In children, it was contrary with a statistically lower median age in girls compared to boys. Children most commonly fractured the tibia (48.4 %), the radius (22.2 %), and the hand (7.8 %). The most fractured segment in children was the tibial shaft (38.5 %). Adults most often fractured the tibia (27.6 %), the radius (13.9 %), and the humerus (13.6 %) and had the proximal tibia as the most fractured segment (18.8 %). 82 % (2724) of fractures in children were treated non-surgically. In adults, 54 % (1850) were treated non-surgically. Tibia fractures were predominant, with children frequently experiencing shaft fractures and adults proximal tibia fractures. Younger, lighter children skiing at a slower speed would benefit from improved ski bindings for fracture prevention. Tailoring ski equipment to an individual's age and sex is crucial for enhancing preventive strategies.