Fracture and dislocation of snowboarder's elbow

Background: This study focuses on the analysis of snowboarding versus skiin g injuries, especially fracture, dislocation, or both, of the elbow, based on 7 years of medical records and roentgenograms of patients injured at a s ki-snowboard area, Mt. Zao National Park, and demonstrates the precise char acteristics of snowboard injury in the elbow region. Methods: A retrospective study of 1,445 injured snowboarders and 10,152 inj ured skiers was undertaken to assess both snowboarding and skiing injuries. Sixty-four cases of snowboarding injuries and 152 cases of skiing injuries were available for precise analysis of fracture, dislocation, or both, in the elbow region. Results: Fractures, dislocations, or both, in the elbow were more frequentl y observed for snowboarders (30 of 64 cases, 46.9%) when compared with that for skiers (26 of 152 cases, 17.1%) (p < 0.001). The rate of dislocation w ith or without fracture of the elbow was also significantly higher for snow boarders (17 of 64 cases, 26.6%) than for skiers (8 of 152 cases, 5.3%, p < 0.001). Seventeen cases of elbow dislocation in snowboarding were all of t he posterior type, which accompanied two coronoid process fractures and two radial neck fractures. Fractures of the coronoid process (five cases), rad ial head (one case), radial neck (five cases), olecranon (one case), proxim al ulnar shaft (one case), and extension-type fracture of distal humerus (f our cases) were the fracture types observed in the analysis. Conclusion: Posterior dislocation; fractures of coronoid process, radial ne ck, and radial head; and extension-type fracture of the distal humerus char acterize the particular and frequent injury mechanism responsible for snowb oarding trauma in the elbow region. Thus, snowboarding injury of the elbow is recognized as a severe injury and is characterized by a frequent risk of posterior dislocation, fracture, or both. The severity of elbow injuries i n snowboarding mainly seems to be due to direct mechanical force on the elb ow, receiving the full impact of falling down, combined with an outstretche d hand and elbow extension, or with an outstretched hand and longitudinal t hrust force, to the proximal radius and ulna and distal humerus.