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Skiing and Knee Fractures

July 17, 2001  

by Sheila Dwyer, Knee1 Staff

Skiers beware: medical researchers have found that knee fractures sustained while skiing are eight times more common than previously realized.

Researchers including Dr. Peter Millett, an orthopaedic surgeon in Vail, CO, studied knee injuries in or near the Vail ski resort during the 1998-1999 ski season. They reported their findings at the American Orthopaedic Society for Sports Medicine meeting in Keystone, CO, earlier in July.

The results showed that knee fractures, which are essentially a type of broken leg, are also more common among good skiers, as compared with beginners and risk-takers. “When you think of someone breaking their leg, you think they have to be going pretty fast and on a steep slope,” said Dr. Millet. “It can happen to the average person on the average run. It’s something that everyone’s at risk for.”

Most of the injuries in the study occurred on intermediate-level slopes with intermediate-level skiers, and many of the injuries happened in the afternoon when snow conditions were beginning to deteriorate, and skiers were tired.

The researchers looked at 110 consecutive tibial plateau fractures, an injury that until now was estimated to comprise less than 1 percent of all ski injuries. When this injury occurs the shin bone, located below the knee, is broken. Millett acknowledges that, while rare, these fractures can cause serious health problems. “It usually requires surgery to have them fixed because the fracture extends into the [knee] joint,” he said.

Women, who have weaker bones than men, were three times more likely to suffer tibial plateau fractures than men. But the injury in men was generally more severe. “The more serious injuries occurred in younger men. Maybe they weren’t reckless but were just skiing at a higher speed,” Millett said.

Over the past 25 years, hospitals located near ski slopes have greatly improved how knee injuries are treated. MRI scans allow a sophisticated view of the injury, and doctors can treat the fractures during surgery by installing plates and screws.

Here are some suggestions on how to avoid a knee injury next time you’re on the slopes:

  • Try to fall forward or to the side. This puts your knee in a more stable position. If you are wearing a free heel boot, the risk of sustaining a tibial fracture is lower because your heel will lift off the ski.
  • Ski with your weight centered over both skis. If one of your ski edges suddenly catches, you will be in position to fall forward.
  • Edge with your uphill ski.
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