A 1-Year Prospective Analysis of Ice Climbing Injuries.

OBJECTIVE: To describe rates, patterns, and causes of acute injuries in an increasingly popular outdoor sport. DESIGN: Prospective cohort study. SETTING: One winter season ranging from November 2011 to March 2011. PARTICIPANTS: Seventy ice climbers from 13 different countries and various performance levels. MAIN OUTCOME MEASURES: Participants were asked to complete a monthly Internet-based survey regarding their completed hours of training and competitions and eventual sustained injuries. RESULTS: During 4275 hours of ice climbing, 42 injuries occurred, of which 81.0% were defined as mild, 16.6% as moderate, and 2.4% as severe. The calculated injury rate was 9.8 injuries per 1000 hours of sports exposure. Intermediate ice climbers had a significantly higher injury risk compared with advanced ice climbers (odds ratio, 2.55; 95% confidence intervals, 1.17-5.54; P = 0.018). About 73.8% of all injuries occurred on a frozen waterfall, icicles, or icefalls, whereas 4.8% occurred on artificial ice walls. The head was the most injured body part (47.6%), followed by the knee (14.3%) and the shoulder (11.9%). The most common types of injuries were abrasions (38.1%), contusions (35.7%), and joint sprains (7.1%). Falling ice was the main circumstance leading to injury (59.5%). All athletes with a head injury wore a helmet; however, only 35.0% mentioned they used protective goggles. CONCLUSION: Ice climbing is a sport with moderate risk for injury with most of the reported injuries being of minor severity. However, severe and fatal injuries, although less common, also occur. Advanced ice climbers with greater experience and skill level have a lower overall injury risk.

The reliability of fetal MRI in the assessment of brain malformations.

OBJECTIVES: To assess the inter- and intraobserver reliability of different fetal MRI measurements in cases of fetal brain malformations and to examine the concordance between ultrasonography (US) and MRI findings. METHODS: Fetal brain MRIs and US findings of 56 pregnant women were retrieved from the institutional database. Standardized fetal brain MRI measurements were performed by 4 observers, and the inter- and intraobserver reliability was determined. Additionally, US and MRI findings were retrospectively compared. RESULTS: The interobserver intraclass correlation coefficient (ICC) was above 0.9 for the cerebellum and posterior horn of the lateral ventricle. The measurements regarding the third ventricle (0.50), the fourth ventricle (0.58), and the corpus callosum (0.63) showed poor reliability. Overall, the intraobserver reliability was greater than the interobserver reliability. US and MRI findings were discordant in 29% of the cases with MRI rendering an extended diagnosis in 18%, a change of diagnosis in 3.6%, and excluding pathological findings suspected on US in 7.1%. CONCLUSIONS: Fetal MRI is a valuable complement to US in the investigation of fetal brain malformations. The reliability of most parameters was high, except for the measurements of the third and fourth ventricles and the corpus callosum.

A prospective study of downhill mountain biking injuries.

BACKGROUND: Downhill mountain biking (DMB) has become an increasingly popular extreme sport in the last few years with high velocities and bold manoeuvres. The goal of this study was to provide information on the pattern and causes of injuries in order to provide starting points for injury prevention measures. METHODS: We performed a monthly e-mail-based prospective survey of 249 riders over one summer season ranging from April until September 2011. RESULTS: A total of 494 injuries occurred during the 29 401 h of downhill exposure recorded, of these 65% were mild, 22% moderate and 13% severe, of which 41% led to a total restriction greater than 28 days. The calculated overall injury rate was 16.8 injuries per 1000 h of exposure. For experts it was 17.9 injuries per 1000 h of exposure, which is significantly higher than the 13.4 for professional riders (OR 1.34; 95% CI, 1.02 to 1.75; p=0.03). A significantly higher rate of injury was reported during competition (20 per 1000 h) than during practice (13 per 1000 h) (OR 1.53; 95% CI, 1.16 to 2.01; p=0.0022). The most commonly injured body site was the lower leg (27%) followed by the forearm (25%). Most frequent injury types were abrasions (64%) and contusions (56%). Main causes of injury reported by the riders were riding errors (72%) and bad trail conditions (31%). CONCLUSIONS: According to our data DMB can be considered an extreme sport conveying a high risk of serious injury. Strategies of injury prevention should focus on improvements in riders' technique, checking of local trail conditions and protective equipment design.

A prospective study of snowkiting injuries.

BACKGROUND: Snowkiting is becoming an increasingly popular extreme sport; however, its injury rates and patterns are unknown to date. PURPOSE: The authors surveyed the injuries in a group of snowkiters over 1 season. STUDY DESIGN: Descriptive epidemiology study. METHODS: The study was conducted over the course of 1 winter season ranging from November 2009 until March 2010; 80 snowkiters were surveyed prospectively. All participants were recruited through contacts with snowkite schools, snowkiting-related web portals, or Internet-based social networks. RESULTS: During 3929 hours of snowkiting recorded, 33 injuries occurred, of which 60.6% were mild; 21.2%, moderate; and 18.2%, severe. The calculated injury rate was 8.4 injuries per 1000 hours of exposure. Most frequently injured body sites were the back (30.3%), knee (24.2%), shoulder (21.2%), and head (21.2%). Upper extremity injuries included 2 shoulder dislocations, a clavicle fracture, and a dislocation fracture of the radial head. Injuries to the lower extremity included 3 knee sprains and 1 anterior cruciate ligament rupture. The most common injury causes were riding errors (75.8%), wind gusts (36.4%), and poor snow conditions (27.3%). When compared with experts (5.1 injuries per 1000 hours of exposure), beginners (20.8 injuries per 1000 hours of exposure) had a significantly increased risk of getting injured (odds ratio [OR] 4.11; 95% confidence interval [CI], 1.34-12.64; P = .008). Athletes who used snowboards for snowkiting purposes were injured almost 3 times more frequently than their colleagues using skis (11.7 vs 4.1 injuries per 1000 hours of exposure; OR 2.85; 95% CI, 1.23-6.57; P = .010). The quick-release system (97.5%), helmet (92.5%), kite leash (83.8%), spine protector (51.3%), and shoulder protectors (20.0%) were the most commonly used protective/safety equipment. CONCLUSION: Snowkiting can be considered a sport carrying a high risk of injury. More caution in assessing local snow conditions and wind gust occurrences is recommended as well as considering using the help and advice of a professional instructor when beginning this action-packed sport. Injury prevention strategies should also include the further improvement of currently available safety equipment.