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To identify whether the introduction of carving skis and related equipment has altered the overall injury rate and/or the pattern of injury location.Comparative case series.In the winter season of 1997-98, when carving skis began to appear on the ski market, all injured skiers requiring evacuation or medical treatment in 70 Austrian ski areas were recorded. Five years later, when most skiers were using carving skis, ski injury data were collected in a representative sample consisting of 5 ski areas from the first study.Data collection on injured skiers included subject demographics, weather and snow conditions, mechanism of the skiing accident, the type of ski used, injury location, and in the second study, additionally the date of the last ski binding adjustment.Frequency of injured body parts.In 1997-98, 1.43 injuries per 1000 skier days were calculated. Out of 17,914 injured alpine skiers, 29.5% of the injured men and 53.0% of the injured women suffered knee injuries. Five years later with the introduction of carving skis, the overall injury rate decreased by 9% but the gender-specific percentages of knee injuries did not change. Female carving skiers not using newly adjusted bindings had a higher risk of knee injury than those with newly adjusted bindings.The maintenance of adequate binding adjustment is especially important for the prevention of knee injuries in female carving skiers.