Safety on the slopes: ski versus snowboard injuries in children treated at United States trauma centers

Purpose: Skiing and snowboarding are popular winter sports. The purpose of this study was to determine differences in injury patterns and severity between children participating in these sports treated at trauma centers in the United States. Methods: Ski and snowboard injuries in children < 15 identified from the 2011–2015 National Trauma Data Bank were compared using t tests, chi squared tests, and multivariable analyses. Time trends were evaluated using the Cochran Armitage trend test. Results: We identified 1613 injured snowboarders and 1655 skiers. Snowboarders were older (12 vs. 11 years, p <.001) and more likely to be male (84 vs. 68%, p <.001). The proportion of ski to snowboard injuries increased over time (p <.001). Skiers had greater median ISS than snowboarders (5 vs. 4, p <.001) but similar severe injuries ISS ≥ 16 (9 vs. 8%, p =.31). Head injuries were more frequent among snowboarders (26 vs. 23%, p =.013). Helmet use was greater in skiers (46 vs. 34%, p <.001). Skiers were more likely to sustain face, chest, and lower extremity injuries. Snowboarders had more abdominal and upper extremity injuries (p <.05). Snowboarders were more likely to undergo CT (20 vs. 16%, p =.008), and skiers were more likely to undergo surgery (25 vs. 22% p =.021). Need for intensive care (12 vs. 13%, p =.43) and mortality (0.3 vs. 0.3%, p =.75) were similar. Median length of stay was greater for skiers (2 days vs. 1 day, p <.001). Conclusion: Many children are treated at United States trauma centers for ski and snowboard injuries. One in 10 is severely injured. Different injury patterns between sports can be used to tailor prevention efforts. However, avoiding head injury and improving helmet use should be a priority for all children on the slopes.