Comprehensive Review of Skiing and Snowboarding Injuries

Brett D. Owens, MD; Christopher Nacca, MD; Andrew P. Harris, MD; Ross J. Feller, MD


J Am Acad Orthop Surg. 2018;26(1):e1-e10. 

In This Article

Head Injuries

Although not typically within the realm of orthopaedic medical practice, an understanding of the sequelae associated with snow sport–related head injuries is needed because these injuries may affect the overall surgical care of a patient, resulting in delays in definitive treatment and difficulty in complying with therapy for other treated injuries. Head injuries account for approximately 15% of all reported snowboarding injuries and are the most common cause of morbidity and death among snowboarders.[7] In a study published in the year 2000, Levy and Smith[8] reported that injuries to the head accounted for approximately 28% of all skiing injuries and 33.5% of all snowboarding injuries. Head injury also tends to be the leading cause of referrals to level I trauma centers after a snowboarding accident, which is why such an injury should be triaged appropriately in the initial trauma evaluation.[9]

Snowboarders have both feet securely fixed to the board, and they face sideways while riding, which inherently causes more ventrodorsal instability than does skiing. Because snowboarders tend to fall backward, they are more prone to occipital trauma, in contrast to skiers, who can use their upper extremities to brace themselves during a fall. Overall, 22% of head injuries are serious enough to cause clinical signs of concussion.[10] Acute subdural hematoma was the most common intracranial injury pattern requiring intervention, a finding consistent with other published literature.[11,12] Traumatic brain injury is fatal among snowboarders and skiers of all ages and is a contributing factor in up to 88% of all injury-related deaths.[10]