Femur fractures in alpine skiers

From the years 1982 to 1989, 377 patients with alpine skiing-related injuries were admitted to St. Anthony's Hospital (a level one regional trauma center). Fifty femur fractures were recorded in 48 patients: 29 femoral shaft fractures (2 open), 15 hip fractures, and 6 supracondylar fractures (2 open). In the femoral shaft fracture group, the predominant fracture pattern was a short, transverse, comminuted fracture, illustrating the high kinetic energy of the accident. In this group, 11 patients returned to skiing, 7 of whom had hardware in place. Of the 10 Garden femoral neck fractures, 4 progressed to avascular necrosis. Three patients required press-fit total hip arthroplasties. Only 4 of these 10 patients returned to skiing. Median injury severity scores were 9.1 in 345 patients (94%), suggesting isolated trauma. Collisions with trees or poles accounted for 32% (15 patients) of all injuries. Follow-up data on return to skiing was available on 43 patients and of these 19 (44%) returned to skiing.