Distal radius fractures in snowboarders

In snowboarding, both feet are secured to a single board. Unlike in skiing, it is difficult to move your feet independently to control the direction of a fall. So when you lose your balance, you instinctively reach forward and put your hands on the ground. Your body weight and the momentum of your descent can then concentrate at the wrist, potentially fracturing the end (distal portion) of the radius, the bone on the thumb side of the forearm.

Falling onto an outstretched hand like this is called FOOSH (fall on outstretched hand). The term is often used not only for snowboarding but also for falls on icy paths and bicycle or inline-skating accidents. A study of snowboarding injuries in Colorado over 10 years found that about half of the injuries involved the upper limbs, with the wrist being the most common site, accounting for 21.6% of all injuries.

Snowboarders are reported to fall forward, toward their toes, in many cases. When you reach forward to break a fall, the wrist bends backward. If your body weight loads the wrist in that position, a bending force acts on the end of the radius. This is the most typical mechanism of the fracture.

The difference becomes clear when compared with skiing. Skiers hold poles and can move their feet independently, whereas snowboarders have both feet secured, making their hands likely to become almost their only support during a fall. This is why snowboarders' wrists bear so much strain.

Developing a sense of balance and learning how to fall take time. First-time riders fall more often and have difficulty anticipating the direction of a fall. A randomized controlled trial examining the effects of wrist braces also found that injuries were more frequent among beginners with fewer than 5 days of snowboarding experience and those using rented equipment. As people snowboard more often, they tend to fall less frequently, and wrist fractures tend to decrease as well.

A wrist brace prevents the wrist from bending backward too far and helps distribute the impact around the wrist. A systematic review pooling 6 studies found lower risk ratios with brace use: 0.23 for wrist injuries and 0.29 for wrist fractures. In a randomized controlled trial involving 5,029 people, there were also fewer wrist injuries in the brace group, with 8 cases compared with 29 in the group without braces.

• Bring a wrist brace. Some products fit inside gloves, while others are built into the gloves. A suitable product allows the wrist to bend forward comfortably while preventing it from bending backward. Many rental shops also offer them for hire.
• If you are a beginner, consider taking a lesson. Learning how to fall on your first day can make the day more comfortable.
• Try to be mindful of not reaching out with your hands when you fall. Bringing your arms toward your body, making fists, and falling in a rolling motion onto your forearms or the side of your body can reduce the concentration of force at the wrist. It may feel unfamiliar at first, but with practice, your body will remember.
• Rest when you are tired. As your legs tire late in the afternoon, you may fall more often. Finishing early is another way to ride safely.

The most typical signs of a fracture are wrist pain and swelling that begin immediately after the fall. Depending on the severity of the fracture, the wrist may look different, or it may be difficult to rotate or bend it.

If your wrist becomes increasingly swollen after a fall, looks different from usual, or hurts severely when you move your fingers, have the wrist assessed promptly. The same applies if your fingers feel numb or tingly or look different in color. Keeping the wrist firmly supported so that it does not move can make traveling more comfortable.