It’s the time of year for skiing injuries

At his time of year I see a steady stream of patients coming back from their skiing holiday with a fracture or other injury. I’m an enthusiastic skier myself and always interested to know where the person had been skiing and how their injury had occurred. This season I saw my first patient injured skiing before Christmas, there are often quite a few after the February half-term and at Easter, with the last patient usually coming through in late April.

If a skier is injured they will usually attend a local medical centre or hospital where they will be X-rayed. If there is a fracture, it may just need treating in a plaster cast, or if a more serious injury surgery might be indicated. It is frequently a grey area as to whether an operation is required or not, and there are always risks associated with having surgery. Some patients I see have had an operation abroad for an injury which in my opinion could have been managed with just a cast. This is particularly the case with people who have been skiing in Austria or Switzerland. The surgery has usually been done well, but may not have been necessary. Over the years I have had a number of patients who have had an operation done abroad very badly such that I have had to re-operate on them to correct the problem.

Most hand and wrist injuries which would benefit from surgical treatment don’t need to have this done immediately, and it will usually be perfectly safe to have a temporary cast applied at the local hospital and to get an orthopaedic opinion on return to the UK a few days later. For acute injuries it should not be a complete cast, but what is called a backslab which is a strip of plaster of Paris held with bandages. This is particularly important if they are flying home. On return to the UK an Orthopaedic surgeon will be able to advise how the injury can be treated. This may by continuing with a cast or splint while the bone heals, or if the bone is very displaced and the fracture is unstable then the pros and cons of surgical intervention will be discussed.

Another group of patients I see are ones who fracture their hand or wrist just before they are due to go on a skiing holiday. This will usually mean they have to cancel their holiday, but I have a few patients who are so desperate to go that they won’t cancel. I’ll do my best to make doing so as safe as possible for them, and I remember a young man I treated a few years ago who brought a ski pole into the clinic, so that when he was having a plaster cast applied we could mould it around the handle of the pole so that he could hold it and ski in his cast.

Mr James Young

BSc (Hons) MBBS MRCS FRCS (Tr & Orth)


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