An article published online in the March 2011 issue of Journal of Neurosurgery backs up the benefits of helmet use — especially among kids.
In the article, “Helmet Use Reduces Skull Fractures in Skiers and Snowboarders Admitted to the Hospital,” researchers studied skull fractures incurred by young skiers and snowboarders and the role helmets play in reducing these head injuries.
According to the article, severe head trauma is the most frequent cause of death and severe disability in skiers and snowboarders and accounts for about 15 percent of all skiing and snowboarding related injuries. A recent meta-analysis concluded that helmet use reduces head injuries by 35 percent, and another recent meta-analysis suggested head injury reductions ranging from 15- percent to 60 percent. The present study is the first to analyze head injury patterns sustained by helmeted versus unhelmeted skiers and snowboarders under the age of 21, as confirmed on CT scans.
The authors reviewed data on head injured skiers and snowboarders treated at two level 1 trauma centers in New England from 2003-2009. The authors focused their research on 57 children (ages 21 and younger). The primary endpoints of interest were the presence of CT findings that included epidural hematoma, subdural hematoma, other traumatic intracranial hemorrhage and skull fractures. The secondary endpoints of interest were the presence of cervical spine injury, the need for a neurosurgical procedure and incidence of death. Noteworthy results from that study group include:
* Helmet usage: 19 helmeted (33.3 percent), 38 unhelmeted (66.7 percent)
* Helmet usage by sport: 30.8 percent skiers, 35.5 percent snowboarders
* Skull fractures: 5.2 percent of helmeted patients suffered skull fractures versus 36.8 percent of unhelmeted patients.
* Helmeted fracture patterns: 1 non-depressed skull fracture
* Unhelmeted fracture patterns: 14 skull fractures, 8 of which were depressed
The authors also cited several studies that attributed a majority of skiing fatalities to head injury:
* Utah study: 88.9 percent of fatal injuries attributed to head injury
* Vermont study: 87.5 percent of fatal injuries attributed to head injury
* Alberta study: 80.0 percent of fatal injuries attributed to head injury
* Switzerland study: 80.0 percent of fatal injuries attributed to head injury
A review of other studies showed compelling evidence that skull fractures sustained by children in skiing and snowboarding pose serious risk. A New Hampshire study reported that 71.1 percent of all children involved in a ski accident and admitted to the hospital had suffered a skull fracture. An analysis of 16 fatal ski injuries in Vermont from 1980-1986 revealed that of the 16 deaths, 14 patients had suffered head injuries and 13 of those were associated with skull fractures.
“We are able to show that helmets are associated with reduced skull fractures in skiers and snowboarders seen at the hospital,” said Dr. Anand I. Rughani, one of the authors of the article. “Given that skull fractures can be an indication of severe brain injury and sometimes associated with intracranial bleeding, a reduction in skull fractures is a compelling finding. Furthermore, we did not see any increase in the risk of cervical spine injuries as some might predict. Although not a focus of our work, other research has shown that helmet use in skiers and snowboarders does not increase risk-taking behavior. This work supports the protective role of helmets in skiers and snowboarders.”
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