Aim: To demonstrate the pattern and mechanism of injury of alpine skiing and snowboarding, and to evaluate the potential risk factors.

Methods: We analysed prospectively all cases of orthopaedic injuries requiring hospital admission that were the result of snowboarding or skiing accidents in the winter of 2000. This included four popular skiing facilities in the South Island of New Zealand.

Results: Seventy-six patients were reviewed. Of those, 30 cases were the results of accidents from snowboarding and 44 cases were from skiing. In addition to appropriate medical evaluations and medical care, a detailed examination was performed on every patient to determine various factors, including demographics, their level of experience and the cause and mechanism of the accident. There were 47 males and 29 females, with an average age of 28 (range: seven to 62)years. Snowboarders tended to be younger men with an average age of 23 years compared with 31 years in skiers. Males constituted 77% of snowboarders and 54% of skiers.

There were 14 patients in the beginners’ group, 32 intermediate, 20 advanced and nine at an extreme-skill level. Thirty-eight patients sustained injuries of the lower extremities, 24 of the upper extremities, 13 of the spine, and one of the pelvis. Lower extremity injuries were more common in skiers (59% of lower limbs, versus 25% of upper limbs), while in snow boarding upper extremity injuries were more common (43% upper limbs versus 36% lower limbs). Ulnar collateral ligament injuries of the metacarpophalangeal joint of the thumb, were far more common in skiers (six in skiers versus one on snowboard). Sixteen patients (nine skiers and six snow-boarders) sustained diaphyseal fractures of their tibiae. In all nine patients in the skiing group, the mechanism of injury was failure of the binding to release resulting in a twisting force to the leg, while in the snowboarding group, three patients (50%) fractured their tibiae on landing badly from a jump and in the other three on colliding with another person or a fixed object.

Conclusions: Lower extremity, equipment-related injuries are common in alpine skiing. The data suggested that currently used bindings are insufficient. Research, technical developments and optimal adjustment of binding are required.