knee injuries in snowdonia

www.mountainmedicine.co.uk Knee injuries in mountain users: a 10-year series of cases requiring SAR assistance in Snowdonia Photo Courtesy of Mike Gibson A child was only very slightly harmed in the course of production of this poster (she had just fallen off her bike!) Daniel Taylor-Sweet Medical Student, University of Glasgow Dr Linda Dykes Consultant in EM Bangor, North Wales Background We wished to ascertain the incidence, associated injuries and pattern of acute knee injuries in mountain trauma casualties, about which we found no prior literature. Methods Patients with knee injuries were identiAied from our database of all mountain casualties brought to Ysbyty Gwynedd ED following contact with Mountain Rescue and/or an RAF helicopter in the 10 year period between 01/01/2004 to 01/01/2014. Results How many were there? 492 (48%) out of the 1029 casualties in the database sustained lowerlimb trauma, with 91 (18%) of these sustaining an acute knee injury, making up 9% of all casualties in the database. What kind of knee injuries were sustained? Most of the acute knee injuries (n=55, 60%) had an ED diagnosis of ‘soft tissue injury’ followed by ‘fractures’ (n=13, 14%), ‘patella subluxation’ (n=12, 13%) and ‘lacerations’ (n=11, 12%). What about the fractures around the knee? The fractures were of the ‘patella’ (n=8), ‘femoral condyle’ (n=3) and ‘tibial plateau’ (n=2). Were the knee injuries isolated injuries or not? 38% (n=35) of patients with knee injuries sustained other injuries during the same incident. What were the demographics of these knee injury casualties? Casualties with acute knee injuries were signiAicantly (p=0.0009) younger (mean 32 years) than those with other lowerlimb injuries (mean 39 years old). What was the outcome following these knee injuries? Unfortunately we have no outcome data for these patients: only 22% (n=20) of patients with an acute knee injury required admission to hospital, and most casualties lived outside North Wales (n=83, 91%) which precluded analysis of the Ainal diagnosis for many of the “soft tissue injuries” and also impeded investigation of eventual outcome. Kneed Help Snowdonia? in Conclusion Around onetenth of all mountain casualties sustain an acute knee injury of some sort, but most are minor injuries not requiring inpatient hospital admission and fractures remain relatively uncommon. Acute knee injuries appear to be signiAicantly more common in younger patients. It is unclear why: possibilities include the nature of activities they were participating in, that older mountain users may be more likely to fracture their ankles than injure their knees when twisting on a Aixed foot, or be related to differing footwear preferences between age groups.

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Poster presented at Traumacare 2015.Photo courtesy of Mike Gibson

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www.mountainmedicine.co.uk

Knee injuries in mountain users: a 10-year series of cases requiring SAR assistance

in Snowdonia

Photo Courtesy of Mike GibsonA child was only very slightly harmed in the course of

production of this poster (she had just fallen off her bike!)

Daniel Taylor-SweetMedical Student,

University of Glasgow

Dr Linda Dykes Consultant in EM

Bangor, North Wales

Background

We wished to ascertain the incidence, associated injuries and pattern of acute knee injuries in mountain trauma casualties, about which we found no prior literature.

Methods

Patients with knee injuries were identiAied from our database of all mountain casualties brought to Ysbyty Gwynedd ED following contact with Mountain Rescue and/or an RAF helicopter in the 10-year period between 01/01/2004 to 01/01/2014.

Results

How many were there? 492 (48%) out of the 1029 casualties in the database sustained lower-limb trauma, with 91 (18%) of these sustaining an acute knee injury, making up 9% of all casualties in the database.

What kind of knee injuries were sustained?Most of the acute knee injuries (n=55, 60%) had an ED diagnosis of soft tissue injury followed by fractures (n=13, 14%), patella subluxation (n=12, 13%) and lacerations (n=11, 12%).

What about the fractures around the knee? The fractures were of the patella (n=8), femoral condyle (n=3) and tibial plateau (n=2).

Were the knee injuries isolated injuries or not? 38% (n=35) of patients with knee injuries sustained other injuries during the same incident.

What were the demographics of these knee injury casualties? Casualties with acute knee injuries were signiAicantly (p=0.0009) younger (mean 32 years) than those with other lower-limb injuries (mean 39 years old).

What was the outcome following these knee injuries? Unfortunately we have no outcome data for these patients: only 22% (n=20) of patients with an acute knee injury required admission to hospital, and most

casualties lived outside North Wales (n=83, 91%) which precluded analysis of the Ainal diagnosis for many of the soft tissue injuries and also impeded investigation of eventual outcome.

Kneed Help Snowdonia? in

Conclusion

Around one-tenth of all mountain casualties sustain an acute knee injury of some sort, but most are minor injuries not requiring inpatient hospital admission and fractures remain relatively uncommon.

Acute knee injuries appear to be signiAicantly more common in younger patients. It is unclear why: possibilities include the nature of activities they were participating in, that older mountain users may be more likely to fracture their ankles than injure their knees when twisting on a Aixed foot, or be related to differing footwear preferences between age groups.
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