Dr. George 14.5

Imagine this: you’re standing atop a scraggy cliff line with little to no coverage to launch off of. Below you the landing is a good 25 feet away into an endless and near-perfect chute. Your photographer Richard Walch and fellow travelers Travis Yamada, Chris Engelsman, and Oliver Holzmann are hanging back, waist-deep in seemingly bottomless powder.

A couple snowballs mark your landing. Puff-nothing but a sweet 40-degree, three-foot-deep landing zone. Yes, you think you’re clear for takeoff. Pop-a picture-perfect method (for my old-school standards, anyway) to … unexpected madness. Unknown to you, in the middle of the chute lies a massive ice blister, turning the supposedly deep powder chute into a 25-foot air-to-sheet-ice reception.The exploding, bone-crushing, and numbing thud of your left knee hitting your face sinks deeply into your inner senses. The impact shatters every blood vessel in your nose, breaking it into unimaginable pieces, tears the sinews from under your lips out, and destroys your left eye’s vision entirely.

As you sit there shocked, seeing pure blackness on one side, and nodding to your buddies that it’s all cool and they should carry on shooting, you notice the massive flood of blood that is completely engulfing your body, and the entire area you are slouched in. The bleeding carries on, not stopping for 40 hours until your face and eyes are swollen from internally soaking up the remaining blood loss.

The location: Russia. Thousands of miles from home, no immediate services, rough ex-army transportation, and bizarre hospital practices. An eight-hour charter flight to Germany, customs agents who just don’t care, three hours of autobahn travel, immense pain, a snowy four-hour one-eyed drive home alone with a face that looked worse than any injury sustained in a gang brawl. And yes, finally, “Hi honey, I’m home.”-Dani Kiwi Meier

Over the last decade, the number of snowboarders increased from one-million to almost five-million worldwide, and with it grew the incidences of head injuries. The head is one of the most vulnerable parts of the body; almost nine to fourteen percent of all injuries are head injuries. In the U.S., the estimated number of head injuries due to snowboarding-related accidents increased by more than five times, from 1,000 in 1993 to 5,200 in 1997. The leading cause of head and neck injuries is falling and hitting the surface, followed by hitting objects and collisions.

What kinds of head injuries are there?
Most head injuries are not severe or life-threatening. Luckily, there have only been a few deaths reported. The most common injuries are cuts around the skull. Concussions due to induced forces are quite frequent as well, and those can lead to unconsciousness directly after the impact. Head injuries can also be associated with an additional injury to the neck.

What do I do in case of a head injury?
Snowboarders who were or are at all unconscious after a fall need immediate medical attention. There is often a memory loss as to how the injury occurred, and depending on how severe the impact was, they should remain under medical supervision for at least 24 hours for their own safety. Note: Never move a snowboarder without competent medical help after a fall if they complain about pain in the neck combined with tingling or numbness of the arms or legs. Don’t forget to keep someone who is injured warm until help arrives.

Due to the large supply of blood in the head, heavy bleeding can occur after a cut. Bleeding should be addressed with immediate compression and some surgical stitches in the emergency room of the nearest hospital. A direct impact to the face that results in large swellings should always be investigated for fractures. For swellings, the application of ice is still the best method. Note: Never put ice directly on the skin or on top of open wounds.

How can I avoid head injuries?
Almost a quarter of all injuries occur when snowboarders go off aa jump or hit a bump. So first of all, don’t overestimate your riding capabilities. Always clear the space where you want to land before you hit the jump. Also, always be aware of the people next to you on the slopes to avoid collisions. Less than five percent of all snowboarders use head protection such as helmets.

Is the use of helmets beneficial?
Head-protection gear such as helmets create a hard shell around your skull so that injuries caused by sharp or pointy objects meeting with the top of the head, back of the head, forehead, or the side of the head above the ear can be avoided. According to recent studies, helmets protect against about 44 percent of all head injuries. As already known from bicycle helmets, they can also absorb part of the impact from forces to the head. Even if the use of head protection does not eliminate all head injuries, almost half of them can be avoided. Helmets are recommended in the halfpipe, especially when trying difficult or new tricks and during competition. Smart freeriders should also use them.

What kind of helmet should I use?
Helmet designs vary. Helmets should not cover your ears, which would inhibit hearing and orientation. They should allow a wide range of peripheral vision and provide sufficient coverage to the back of your head without compromising your neck movements. Features of a good helmet include a well-padded liner for maximum shock absorption, a good fit, warmth, and adjustable ventilation systems. A helmet that doesn’t fit well can be dangerous. Also, always close your helmet fixation correctly. Kiwi won’t forget that Russian experience, and we’re all glad something more serious didn’t happen.

Dr. G. AhlbÑumer, better known as Dr. George, is an orthopedic surgeon at the well-known Klinik Gut in St. Moritz, Switzerland. Apart from surgery, he specializes in injury prevention. You can e-mail Dr. George directly at dr-george@biomex-protection.com.