Alpine ski bindings and injuries - Current findings

In spite of the fact that the overall incidence of alpine ski injuries has decreased during the last 25 years, the incidence of serious knee sprains u sually involving the anterior cruciate ligament (ACL) has risen dramaticall y since the late 1970s. This trend runs counter to a dramatic reduction in lower leg injuries that began in the early 1970s and to date has lowered th e risk of injury below the knee by almost 90%. One of the primary design objectives of modern ski boots and bindings has b een to protect the skier from tibia and ankle fractures, So, in that sense, they have done an excellent job. However, despite advances in equipment de sign, modern ski bindings have not protected the knee from serious ligament trauma. At the present time, we are unaware of any binding design, settings or func tion that can protect both the knee and lower extremities from serious liga ment sprains. No innovative change in binding design appears to be On the h orizon that has the potential to reduce the risk of these severe knee injur ies. Indeed, only 1 study has demonstrated a means to help reduce this risk of serious knee sprains, and this study involved education of skiers, not ski equipment. Despite the inability of bindings to reduce the risk of severe knee injurie s there can be no doubt that improvement in ski bindings has been the most important factor in the marked reduction in incidence of lower leg and ankl e injuries during the last 25 years. The authors strongly endorse the appli cation of present International Standards Organisation (ISO) and American S ociety for Testing and Materials (ASTM) standards concerning mounting. sett ing and maintaining modern 'state of the art' bindings.