Introduction: Snowmobiles are increasingly popular recreational, all-terrain utility vehicles that require skill and physical strength to operate, given their inherent maneuverability, acceleration and top speed-capabilities. These same characteristics increase the risk of injury with operation of these vehicles, particularly neurological injury. We characterize our series of 107 patients involved in snowmobiling accidents.
Methods: From January 2004 to January 2012, all snowmobiling-related injuries referred to our regional trauma center were reviewed. Information had been recorded in the hospital's trauma registry, and medical records were retrospectively reviewed for data pertaining to the injuries, with particular emphasis on neurological injuries and any associated details.
Results: A total of 107 patients were identified. Ninety percent of injured riders were male. The mean age was 34.4 years (range 10-70), with 7% younger than age 16. The mean Injury Severity Score was 12.0+/-0.69 (range 1-34). Although not documented in all patients, alcohol use was found in 7.5% of the patients and drug use found in 1 patient. Documentation of helmet use was available for only 31 of the patients; of which 13% were unhelmeted. Causes included thrown/flipped/roll-over(33%), striking a stationary object(27%), being struck by a snowmobile(9%), striking another snowmobile(5.5%) or car/train/truck(5.5%), other(2%) or unspecified(18%). Head injuries occured in 35% patients, including concussion, SAH, SDH, contusion, and facial/skull fracture. Spinal fractures occured in 21% of the patients. Fractures to the thoracic spine were the most common(50%), followed by the cervical(41%) and lumbar(36%) spine. There were also three brachial plexus injuries, one tibial nerve injury, and one ICA dissection. Average LOS was 4.98+/-0.56 days. Disposition was home(78%), home with services(12%), rehab placement(9%) and one death. Details regarding other systemic injuries will also be reviewed.
Conclusions: Snowmobiles are a significant source of multitrauma, particularly neurological injury. Neurosurgeons can play key roles in advocating for neurological safety in snowmobiling.
Patient Care: This review will raise awareness about the spectrum of neurological injury encountered in snowmobiling and potential avenues for prevention. Hopefully reviews such as this will continue to remind others of the role neurosurgeons may play in neurological sports medicine.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the spectrum of neurological injury seen in snowmobiling participants, 2) Discuss, in small groups, the means by which these injuries can be avoided or reduced, 3) Identify root causes of injury to develop strategies for prevention.