Considering the health benefits of skiing and the advances in equipment, the risk–reward ratio of participating in this sport has been optimized.1 On the basis of data on the ski patrol accidents that occurred at Styrian resorts in Austria during the 2014–2015 ski season, Castellani et al2 estimated that the average daily number of injuries per 1000 skiers was 0.7, a slight increase (0.2 cases) over that 7 years prior. The average daily number of injuries per 10000 skiers at the Chongli ski resorts during the 2017–2018 and 2018–2019 ski seasons was 27.9. The corresponding rate at the Japanese ski resorts during the 2019–2020 ski season was 0.93 per 10, 000 skiers. Overall, the Chongli ski resorts had a higher rate of injuries.
Most of the ski injuries at Wanlong Ski Resort (66.5%) and the Japanese ski resorts (80.0%) were falls not caused by collisions. However, 31.3% of the injuries at Wanlong Ski Resort resulted from collisions with other skiers, a much higher rate than at the Japanese ski resorts. This may be ascribable to the fact that Wanlong Ski Resort has more traffic. In general, technical errors, excessive speed, or loss of balance can all result in falls. Quinlan et al.14 noted that skiers who sustained wrist fractures had less experience and more falls, and that the injuries were mainly linked to jumping movements or technical skill level. Similarly, Sakamoto et al.16 suggested that with regard to injury prevention, both skiers and snowboarders should take extra care when performing jumping movement. Another study7 suggested that professional skiers and snowboarders may have a higher risk of serious injury than beginners because they often engage in highly technically challenging movements.
The largest proportion of injuries at both the Chinese and Japanese ski resorts (35.7% and 34.2%, respectively) occurred among individuals aged between 21 and 30 years. However, significantly more injuries at the Japanese ski resorts were sustained by older individuals, with 227 cases (8.6%) in individuals aged over 60 years. This may be attributable to both societal aging and the high popularity of skiing in Japan. In a study by Patrick et al,12 injuries were found to be more likely to occur among skiers and snowboarders aged between 46 and 55 years, had never received professional training, or used rental gear. Girardi et al6 indicated that skiers aged 60 years and older have a higher injury severity score (ISS). In another study, a difference in age between snowboarders and skiers with severe injury (defined as an ISS higher than 15) was observed. Specifically, the severely injured skiers and snowboarders were aged 38 and 20 years, respectively, on average.4
Studies12, 17 have noted that the knee joint is one of the most common sites of ski injuries; this is in line with the present results that knee joint injuries accounted for 24.9% and 28.4% of the ski injuries at the resorts in China and Japan, respectively. In a study by Sakamoto et al,16 calf fractures comprised 39.6% of the fractures sustained in skiing accidents. In another study, skiers had a higher rate of knee joint injury, femoral fractures, and calf fractures than snowboarders, as well as a higher level of injury severity (ISS > 9).10 In short, skiers were more likely to sustain lower limb injuries.
In a case–control study, the injury rate of snowboarders fluctuated over time but was still higher than that of skiers.8 Wrist, shoulder joint, and ankle injuries were more common among snowboarders, whereas knee joint and ligament injuries were more prevalent among skiers.8, 18 In the present study, shoulder joint injuries were common (17.7%) among snowboarders at the Japanese ski resorts, whereas injuries to the hands and fingers (16.7%) were more common among those at Wanlong Ski Resort, consistent with the literature. Maat et al.10 observed that concussions and lower limb fractures were more common among snowboarders than skiers. The direction of falls may determine the body parts injured. In a descriptive epidemiological study of 1918 cases of upper extremity injuries sustained in snowboarding falls, wrist fractures and elbow dislocations (68.1% and 63.5%, respectively) were more likely to occur in backward falls. As for forward falls, shoulder joint dislocations (68.9%) and upper arm fractures (60.7%) were the most common injuries.19
In the Japanese ski resorts, the rate of helmet use among injured skiers increased from 43.2% in the 2018–2019 ski season to 48.2% in the 2019–2020 ski season, and that among injured snowboarders increased from 22.9–24.4%. Although the rate of helmet use among Japanese skiers approached 50%, it is not comparable to that of the American and European skiers (approximately 80%). No record of helmet use was found at the two Chongli ski resorts. Follow-up studies involving the collection of statistics on the observed increase in both ski and snowboarding injuries are necessary. Severe injuries are common in both skiing and snowboarding; therefore, precautions (e.g., wearing helmets and the provision of information on injury prevention) must be taken.3
Our study still had some limitations. First, the data of the Japanese ski resorts merely focused on the February, 2020. Second, compared with the 47 ski resorts in Japan, we didn’t have enough ski resorts to collect data, which might have negative effects on results. However, the study was the few ones that study ski injuries between China and Japan.