Skiing-related injuries to the shoulder

An analysis of 135 consecutive shoulder injuries seen in one clinic during a single ski season revealed anterior dislocation to be the most common ailment, constituting 52% of the total. Rotator cuff tears accounted for 20% of the total, followed by acromioclavicular (AC) separations (18%) and a miscellaneous group of contusions and isolated fractures comprising the other 10%. All of the shoulder dislocations were anterior, most were primary (81%) and men (83%) were involved more frequently. Twenty-four percent of the dislocations were thought to be equipment related. At follow-up examination three to four years after injury, a significant number (41%) were still symptomatic either from a recurrence (18%) or pain and weakness (23%). Patients with rotator cuff tears tended to be about ten years older than the average skier. Their injuries were usually a result of a fall on ipsilateral arm and were not equipment related. Of the 13 patients responding after a three-year follow-up period, most (10/13) were asymptomatic. There were 24 AC separations. All resulted from a direct fall on the shoulder. Sixty percent were first degree, 22% were second degree, and 18% were third degree. About one-third of the respondents with first and second degree injuries were still having significant pain at three-year follow-up examination. The most frequent isolated fracture was a minimally displaced fracture of the greater tuberosity (only three cases in 135 injuries), but this same fracture occurred in 10% of the shoulder dislocations.