Ski Injury Trauma Gallery Original Pictures
-
Upload
surgicalgown -
Category
Documents
-
view
214 -
download
0
Transcript of Ski Injury Trauma Gallery Original Pictures
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
1/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
Introduction:
People are surprised to hear that you can snow ski in Australia.
In fact Australia has a snow covered area bigger than Europe. Of course the
Snow is thinner than that in the US or Europe, but at least here you can ski
In the sun (in bikinis or shorts-the ULTIMATE experience). There are few avalanches.
I collected this data on the 10,000 injuries I personally treated 1983-86(incl)
In Perisher Valley, NSW (E.Sherry et al.Trends in skiing injury type and rates in Australia.
A review of 22,261 injuries over 27 years in the Snowy Mountains.
Med J Aust. 1991 Oct 21; 155(8):513-5)
(all this material is copyright).
History of sport
CPR on the slopes Types of injuries Perisher Valley (PV), NSW
Development of skis Dev. of boots, soft Dr John Shedden, first to
from strap in to leather to firm hold collect stats in NSW
Binding release.
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
2/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
(
I collected Risk factors Location Over view
data on > 20,000
injuries ( 1983-86).
Background;
A prospective study of 1850 skiing injuries which occurred during the 1983 skiing season in
Australia, all injuries were seen and treated by the same medical practitioner, showed upper
extremity injuries and lower extremity injuries were almost equally represented (36% and 42% of
the total number of injuries, respectively); injuries to the head, face and neck accounted for 17% of
the total number of injuries. The injury rate of 3.80 per 1000 skiers establishes skiing as a safe sport.Attention is drawn to the high incidence of facial lacerations and of disruption of the ulnar collateral
ligament of the metacarpophalangeal joint of the thumb ("skier's thumb"). It is recommended that
both competitive and recreational skiers wear helmets with attached visors. With adequate medical
personnel and facilities, over 90% of injuries can receive definitive primary treatment on location;
this results in minimum patient discomfort, complications. And hospital costs. (E Sherry. Skiing
injuries in Australia.Med J Aust. 1984 Apr 28; 140(9):530-1).
The trends in the rate and type of skiing injuries in Australia.
A retrospective analysis. Skiing injuries in the Snowy Mountains, NSW, from 1962 to 1988.
All injuries were seen and treated at the Ski Injury Clinic in Perisher Valley.
A total of 22,261 injuries were seen over this 27 year period (data for 1963, 1964, 1966, 1977, 1978, 1981 and 1982
were missing).
Injured skiers were treated at the Clinic with a small number sent to main centres for tertiary care.
The overall injury rate (1962-1988) and the specific injury rate for six subgroups of injuries (1974-1988) werecalculated.
The overall injury rate declined dramatically over this period.
The incidence of tibial fractures, ankle injuries and lacerations also declined. Upper body injuries continue to rise
although this trend was not statistically significant.
There was a statistically significant increase in knee injuries.
The trends reported here are similar to those overseas except that the incidence of thumb injuries has not
changed in Australia. The changes in the rates of lacerations, and tibial and ankle injuries can be related to
improvements in ski bindings and boots.
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
3/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
PV on a busy Injury trending down Changing types of injuries
Weekend, 20,000
Skiers on slopes
Lower limb injuries Injury rate
X- country lower rate Because more isolated
but more severe.
Nordic Injuries:
A retrospective study of 88 nordic skiing injuries from the 1984 and 1985 skiing seasons in Australia is presented. To
our knowledge, this is the largest study to date of such injuries. These injuries are compared with alpine skiing injuries
from the same medical clinic for the 1985 skiing season.
There was a much lower incidence of injury from nordic skiing; however, when injuries did occur, they tended
to be more serious than those of alpine skiing and frequently required immediate evacuation to hospital for
treatment.
As the nordic skier is relatively isolated from medical services, these findings need to be considered in the future
planning of rescue services for such skiers.
(E Sherry et al.Hazards of cross country skiing. Aust Fam Physician. 1987 Jun; 16(6):851); E Sherry et al.
Nordic (cross-country) skiing injuries in Australia. Med J Aust. 1987 Mar 2; 146(5):245-6).
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
4/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
Norwegian gold miners Postman Poling on skis Skiing from antiquity
on skis first to ski here
Helicopter down Slope preparation- very important to prevent injuries
SHL dislocations common Also A/C jnt injuries
Beware- lunate dislocation
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
5/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
Fx femur, use MAST suit Dislocation knee (easy to reduce);
Disloc. Hip (hard to reduce)
(E Sherry. Complete dislocation of the knee.
Med J Aust.1985 May 13; 142(10):577).
Post hip disloc. Ankle Fx., common Fib Fx at top of boot Ankle held
In old or loose boots. firmly in
new boots.
Blood at tip penis= pelvic Fx Knee injuries- common
(ruptured urethra)
Fx femoral shaft Open Fx tibia
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
6/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
Tibial Fx- 2 types: spiral & transverse (boot-top).
Subtalar dislocation
Splint lig. Skiers tb, bony
Skiers tb avl UCL/MCP,
UCL/MCP related to ski poles
Arm Fx.s Fx humerus. Easy to miss Scaphoid Fx
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
7/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
Lacerations common from
Ski edges (razor sharp)
Of the tongue, Of the lip Of the ear
Ski stock into (van Gogh injury)
Skiers mouth.
Of the scrotum Easily fixed
(Other case: E Sherry et al. Torsion of the testis in a skier.
Med J Aust. 1986 Mar 17; 144(6):332-3).
Arms Of the scalp
(Crucifixion (exclude skull Fx)
Injury)
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
8/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
Death in the afternoon: One avalanche (1953)One death per one million skier days
(E Sherry et al. Deaths associated with skiing in Australia: a 32-year study of cases from the Snowy
Mountains. Med J Aust. 1988 Dec 5-19; 149(11-12):615-8)
Trauma:Mainly Head Injuries
Broken Neck, fall, x-country, 24yo, male
Death from Skiing:
The first study of skiing-related deaths in Australia--a 32-year study of skiing-related deaths in the Snowy
Mountains.
We report 29 such cases;
eight subjects died of TRAUMA,
15 subjects died of CARDIOVASCULAR CAUSES,
and six subjects died of HYPOTHERMIA.
The over-all incidence of death = 0.87 deaths per million skier-days;
-Trauma-related deaths was 0.24 deaths per million skier-days;
-Cardiac-related deaths was 0.45 deaths per million skier-days;
-Hypothermia-related deaths was 0.18 deaths per million skier-days.
These findings compare most-favourably with US figures.
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
9/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
Mainly heart attacks, Hard to resuscitate Aussies dont understand the cold;
in the cold. new-comers often turn up in shorts and thongs
In sun, snows melts # ribs, pneumo-thorax
Quickly, exposing dangerous terrain
Hypothermia:
Even in relatively temperate environments, accidental hypothermia is a potentially lethal complication
of exposure. We have reviewed our experience of accidental hypothermia among recreational alpine
skiers at an Australian resort during the 1983 and 1984 seasons.
There were 19 cases of accidental hypothermia, which occurred in 10 men and nine women who were
aged between six and 47 years (mean age, 15.9 years) and who had rectal temperatures that ranged
from less than 35 degrees C to 36 degrees C.
The temperature at presentation to the Ski Injury Clinic was less than 35 degrees C in seven cases.
One patient presented to the Clinic with a gastrointestinal haemorrhage in addition to hypothermia,
and one was initially thought to be suffering from alcohol intoxication. Two patients were lost in the
snow overnight. All patients were removed from the snow, changed into warm dry clothes where
necessary, and their body temperatures allowed to return to normal spontaneously (17 patients), or
were exposed to heat actively by means of inhaled, heated, humidified air (two severely obtunded
patients). All patients responded satisfactorily.
There were no deaths and no sequelae. We conclude that all skiers should be advised to wear effective
thermal insulation, and to ski with a partner to ensure that adequate care is taken to prevent
accidental hypothermia. Inhalational "warming" is effective in the treatment of hypothermia in
obtunded patients.
(E Sherry et al. Hypothermia among resort skiers: 19 cases from the Snowy Mountains. Med J Aust.
1986 A r 28 144 9 :457-61 .
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
10/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
Near misses, use of much more likely to die in MVAs
alcohol and drugs, in-experience around resorts.
( Aussies brought up on
Surf board NOT skis)
#1. 17yo M, never skied before, drunk, smoked joint, no lessons, steep slope, Fx skull, residual
hemiplegia.
#2. 33yo M, doctor-country skied alone, facial injuries and fractures, happened to be found by ski rescue
group on an exercise.
Childrens Fx. More serious, should wear helmets.
Childrens Skiing Injuries:
Skiing is one of the most popular winter sports for adults and children in Australia. While much is
known about the epidemiology of skiing trauma in adults, little has been written about the patterns
of skiing injury in children in Australia. During the 1984 ski season, the injuries and risk factors of
149 children were compared with those of 1093 adults who were injured over the same period.
Although Australian children were found to be possibly less prone to injury than were adults, they
did sustain more serious injuries, in particular, fractures of the tibia.
The significantly different associated risk factors that are thought to be responsible were the
greater number of children who were injured in collisions and ski-lift accidents, and inadequate
bindings on their skis. Such shortcomings are correctable; children require better boot-bindings
and greater supervision on the ski-slopes.
(Children's skiing injuries in Australia. Med J Aust. 1987 Feb 16; 146(4):193-5).
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
11/12
Ski Trauma in Australia 1953-1990
Eugene Sherry MD FRACS
ALL TREATED: Apply paddle pop to leg
Kookaburra, broken leg
The Future New wave: snow boarding
Medical Olympic Games
In Snow
Miscell:
(E Sherry.Medical problems in skiers.
Med J Aust. 1985 Jul 22; 143(2):92)
S/C Fx lower femur Ski tube tunnel on fire prior to season
Bad sunburn All sorts of medical and surgical
( excl. sunstroke) problems( strangulated haemorrhoids)
-
8/14/2019 Ski Injury Trauma Gallery Original Pictures
12/12