98例儿童滑雪运动损伤的临床特点及处理策略分析

Pediatric skiing and snowboarding injuries in China:clinical characteristics and treatment options:a report of 98 cases

目的分析并总结我国儿童滑雪伤的临床特点。方法回顾性分析2019年12月至2020年12月因滑雪运动损伤就诊于北京积水潭医院小儿骨科的98例患儿临床资料。其中男62例(63.3%,62/98),女36例(36.7%,36/98);患儿平均年龄为9.8岁,范围在4.4~14.0岁;单板滑雪运动致伤患儿51例(52.0%,51/98),双板滑雪致伤患儿47例(48.0%,47/98)。分析患儿的年龄性别分布、损伤部位、损伤类型、受伤至就诊时间及治疗方案的选择,总结儿童冰雪运动损伤的临床特点。结果98例患儿中,软组织损伤15例(15.3%,15/98),以膝关节扭伤(33.3%,5/15)及大腿损伤(20.0%,3/15)最为多见;骨折83例(84.7%,83/98),以胫腓骨干骨折(38.6%,32/83)和尺桡骨远端骨折(20.5%,17/83)发生率最高。单板滑雪损伤最常见的部位为腕关节周围(27.5%,14/51)及小腿(27.5%,14/51),而双板滑雪以小腿损伤最为常见(40.4%,19/47)。35.7%(35/98)的患儿因不慎摔倒受伤,19.4%(19/98)的患儿因装备型号不匹配受伤,6.1%(6/98)的患儿因雪板脱离装置失效受伤,其余受伤原因包括操作不熟练、被人撞伤、跨级别滑雪及疲劳。15例软组织损伤患儿中,1例(6.7%,1/15)患儿因大腿软组织裂伤行清创缝合,其余保守治疗。83例骨折患儿中,11例(13.3%,11/83)患儿接受手术治疗;24例(28.9%,24/83)接受闭合复位石膏固定;47例(56.6%,47/83)接受原位石膏或支具固定;1例(1.2%,1/83)患儿予制动休息观察。结论我国儿童滑雪伤与传统滑雪国家报道的临床特征整体类似,但又具备自身特点:①我国儿童参与单板运动比例较高,上肢伤比例相对较高;②整体运动水平相对较低,体验式滑雪受伤比例较高;③需要手术治疗的严重外伤相对较少。

Objective To explore the clinical characteristics of pediatric skiing and snowboarding injuries in China and to discuss the corresponding prevention&treatment strategies.Methods This retrospective descriptive study analyzed the demographic structures,predilection sites,common types and treatment options of pediatric skiing and snowboarding injuries by summarizing medical records and radiological data of all skiing and snowboarding injury patients during 2019-2020 skiing season.A total of 98 consecutive patients of skiing&snowboarding injuries were recruited.There were 62 boys(63.3%)and 36 girls(36.7%)and with an average age of 9.8(4.4-14.0)years.There were snowboarders(n=51,52.0%)and skiers(n=47,48.0%).Clinical characteristics of such injuries and prevention&treatment protocols were reviewed.Results Among 15 soft tissue injuries(15.3%,15/98),the most common sites were knee(33.3%,5/15)and thigh(20.0%,3/15).Among the 83 fractures(84.7%,83/98)the most common types were tibiofibular shaft fracture(38.6%,32/83)and distal radioulnar fracture(20.5%,17/83).Wrist(27.5%,14/51)and lower extremity(27.5%,14/51)were the most common sites in snowboarders.Lower extremity(40.4%,19/47)was the most common site in skiers.The causes were careless fall(35.7%,35/98),poor fitting equipment(19.4%,19/98)and failed release of bindings(6.1%,6/98).Other causes of injuries included inexperience,colliding into others,choosing a wrong slope and fatigue.Among 15 soft tissue injuries,one(6.7%,1/15)with thigh laceration received debridement and wound closure while the remainders were conservatively treated with rest and observation.Among 83 fractures,11(13.3%,11/83)were operated,24(28.9%,24/83)underwent closed reduction and splint/cast fixation,47(56.6%,47/83)were fixed by splint in situ and 1(1.2%,1/83)received rest and immobilization.Conclusions The Chinese pattern of pediatric skiing and snowboarding injury is largely similar to what reported in other traditional skiing countries.However,there are some distinctive features.Firstly,a higher proportion of snowboarders caused a greater incidence of upper extremity injuries;Secondly,the overall level of snow sports in China is relatively elementary and novices are more vulnerable;Thirdly,severe injuries requiring surgery are relatively few.