Epidemiology of Lower Leg Fractures at a Colorado Ski Resort

Lower extremity fractures are relatively common in winter sports. This retrospective descriptive study evaluated the demographics, injury mechanisms, and environmental factors associated with lower leg fractures (below the knee, excluding tibial plateau and fibular head fractures) among patients treated at a Colorado clinic during the 2012/13 to 2016/17 ski seasons. Chart review confirmed diagnoses and assessed associated factors. A total of 346 lower leg, ankle, and/or foot fractures were identified, representing 5.4% of all visits. The average patient age was 33.1 years (range 4-74), with 60.7% male. Most injuries were ski-related (84.7%). The majority of fractures were sustained among skiers and snowboarders who self-identified as beginner or intermediate skill level (64.8%), on easy or intermediate runs (64.9%). The most common injuries were complete tibia/fibula fractures (36.4%), isolated tibia fractures (28.3%), and lateral malleolus fractures (26.9%). Of the complete tibia/fibula fractures, 57.0% were "boot-top" fractures. Danis-Weber B was the most frequent type of lateral malleolus fracture (73.6%). Only 12 foot fractures were recorded. In conclusion, lower leg fractures were more common in skiers than snowboarders and in men than women. Most fractures occurred on mild-to-moderate runs, with lower risk in older individuals. Tibia/fibula fractures were most common, followed by lateral malleolus fractures.