Unique aspects of downhill ski injuries part 1: epidemiology and equipment.

Skiing is an exciting sport with a significant potential /or serious injury. This potential for injury can be minimized but never entirely eliminated by modern safety equipment.Upper extremity injuries have become relatively more common as the incidence of lower extremity injuries has decreased. Ankle and foot injuries have become infrequent since the advent of the rigid plastic boot, while the incidence of knee injuries has remained essentially constant.Three major mechanisms of injury to the lower extremity include external rotation and abduction, forward fall, and internal rotation. Each mechanism can produce a distinctive set of injured structures.The "skier at risk" is characterized by a lower level of ability, lighter weight, and extremes of age. Injuries can be minimized by purchasing good quality equipment and maintaining it properly; discarding obsolete equipment; using ski brakes, antifriction devices and pistol grip poles; using multirelease bindings for beginners or intermediates; good physical conditioning; taking ski lessons and coupling this with skiing experience; and skiing in control and using common sense on the slopes.Areas which need the most improvement in equipment design include multi-release bindings suitable for all skiers and children's boots.