Wrist guards should be compulsory for school-aged

snowboarders.

Research presentation ACRRM 5th Scientific

Forum

Dr Graham Slaney

Outline

• Background• Study objective• Study design• Results• Conclusion

Mt Buller Medical Centre

• Mt Buller - one of Australia’s busiest ski resorts

• 300 000 skier days per season on average

• Services all the local medical needs for Mt Buller in winter

• About 2500 patients per season• 100-120 wrist fractures per season• 2 doctors, 3 nurses, 1 radiographer• Ski patrol services ski slopes

Background - Wrist injuries

• Snowboarders have 2.4 times as many fractures as skiers1

• Upper limb injuries account for 50%2

• 56% of upper limb injuries are fractures3

• Wrist fractures alone account for nearly a fifth of all injuries in snowboarders

• Impact rather than torsional4

• Possibility of force transfer more proximate5

1. Bladdin (1993) 2. Young (1999) 3. Idzikowski (2000) 4. Pino (1989) 5. Hagel (2005)

Study Objective

To ascertain the association:• between wrist guard use and wrist

fracture in snowboarders in Australia

• between wearing wrist guards and the severity of wrist and elbow injury

Study design

• Case control study 2004 and 2005 ski seasons

• Cases - snowboarder seen at clinic with fractured wrist (n = 119)

• Controls - snowboarder seen at clinic for any reason other than fractured wrist (n = 375)

• Questionnaire about wrist guard use and snow sport behaviour

• Clinic staff recorded details of injury• Logistic regression used to determine adjusted odds ratios

Characteristics associated with Wrist

Fracture

Study Results - Wrist Fracture

• Adjusting for significant variables• Odds of having worn wrist guards lower in

snowboarders with wrist fracture (cases)• Adjusted OR = 0.58; 95% CI, 0.32–1.04;P = 0.07• Wearing wrist guards in Australia reduces wrist

fracture injury by about 42%

Study Results - Elbow Injury

15 elbow injuries amongst the 494 snowboarders

• 5 soft tissue– 4/86 wearing wrist guards– 1/391 not wearing wrist guards– adjusted OR, 17.6; P = 0.01

• 10 elbow fracture or dislocation– 3/86 wearing wrist guards– 7/391 not wearing wrist guards– adjusted OR, 1.84; P = 0.39

Wrist guards protective of overall injury severity

Conclusions

Snowboarders wearing wrist guards:• Elbows protected – important new finding• Reduce wrist fracture injury in Australia by

about 42%• Data consistent with international literature

(52% to 87%)6

• Novices strongly recommended• Mandatory for School-aged children

6. Russell (2007)

Acknowledgements

• Thanks to my supervisors Phil Weinstein & Judith Finn

• Thanks to the staff at the Mt Buller Medical Centre

• Thanks to the patients for participating in the study and completing the forms

• Thanks to my 15 year old daughter, Caitlin

References1. Bladin C, Giddings P, Robinson M. (1993) Australian

snowboard injury data base study. A four year prospective study. The American Journal of Sports Medicine 21(5) 701-704

2. Young CC, Niedfelt MW. (1999) Snowboarding injuries. American Family Physician 59(1):131-136.

• Idzikowski JR, Janes pc, Abbott PJ. (2000) Upper extremity snowboard injuries. Ten year results from the Colorado snowboard injury survey. The American Journal of Sports Medicine 28(6):825-32

• Pino EC, Colville MR. (1989) Snowboard injuries. The American Journal of Sports Medicine 17(6):778-781

• Hagel B, Pless IB, Goulet C. The effect of wrist guard use on upper-extremity injuries in snowboarders. Am J Epidemiol 2005; 162: 149-156.

• Russell K, Hagel B, Francescutti LH. The effect of wrist guards on wrist and arm injuries among snowboarders: a systematic review. Clin J Sport Med 2007; 17: 145-150.