Fractures sustained by slipping on ice or snow: an epidemiological study of 50,500 fractures from the Swedish Fracture Register
DOI:
https://doi.org/10.2340/17453674.2025.43186Keywords:
Epidemiology, Foot and ankle, Fractures, Statistics, WristAbstract
Background and purpose: Despite numerous patients sustaining fractures annually due to slipping on ice or snow, descriptive studies are scarce, which may result in less systematic management and prevention. We aimed to analyze fractures in adults sustained by slipping on ice and snow in Sweden using data from the Swedish Fracture Register (SFR).
Methods: Data on all patients ≥ 18 years registered in the SFR between January 1, 2015 and December 31, 2022, with a fracture sustained by slipping on ice or snow was extracted. Descriptive statistical analyses were performed.
Results: During the study period, 50,500 fractures were registered as sustained by slipping on ice or snow, representing 9% of all registered fractures in the SFR during the same period. 60% of the fractures affected the upper extremity. The mean age at the time of fracture was 61 years (18–105) and almost 70% of fractures were seen in women. The most common fractures were to the wrist (34%), ankle (18%), proximal humerus (11%), and hip (10%).
Conclusion: Almost 1 in 10 fractures is sustained by slipping on ice or snow. The most common fractures are related to the wrist and the ankle. The majority of fractures affect the upper extremity, and two-thirds are sustained by women. Protective shoe wear, and better snow and ice clearance, could potentially have a large effect on injury prevention.
Downloads
References
Yeung M, Schweitzer C, Wang D, Weaver C, Lang E. Orthomageddon: a retrospective cohort study of weather-dependent variations in emergency department volume in a Canadian city. Am J Emerg Med 2020; 38(4): 815-18. doi: 10.1016/j.ajem.2019.12.009. DOI: https://doi.org/10.1016/j.ajem.2019.12.009
Cashman J P, Green C J, McEllistrem B, Masterson E, Condon F. The effect of inclement weather on trauma orthopaedic workload. Ir J Med Sci 2011; 180(3): 679-82. doi: 10.1007/s11845-011-0699-z. DOI: https://doi.org/10.1007/s11845-011-0699-z
Weston-Simons J, Jack C M, Doctor C, Brogan K, Reed D, Ricketts D. The impact of snow on orthopaedic trauma referrals. Injury 2012; 43(7): 1033-6. doi: 10.1016/j.injury.2011.12.018. DOI: https://doi.org/10.1016/j.injury.2011.12.018
van den Brand C L, van der Linden M C, van der Linden N, Rhemrev S J. Fracture prevalence during an unusual period of snow and ice in the Netherlands. Int J Emerg Med 2014; 7: 17. doi: 10.1186/1865-1380-7-17. DOI: https://doi.org/10.1186/1865-1380-7-17
Björnstig U, Björnstig J, Dahlgren A. Slipping on ice and snow: elderly women and young men are typical victims. Accid Anal Prev 1997; 29(2): 211-15. doi: 10.1016/s0001-4575(96)00074-7. DOI: https://doi.org/10.1016/S0001-4575(96)00074-7
Al-Azzani W, Adam Maliq Mak D, Hodgson P, Williams R. Epidemic of fractures during a period of snow and ice: has anything changed 33 years on? BMJ Open 2016; 6(9): e010582. doi: 10.1136/bmjopen-2015-010582. DOI: https://doi.org/10.1136/bmjopen-2015-010582
Rydberg E M, Wennergren D, Stigevall C, Ekelund J, Moller M. Epidemiology of more than 50,000 ankle fractures in the Swedish Fracture Register during a period of 10 years. J Orthop Surg Res 2023; 18(1): 79. doi: 10.1186/s13018-023-03558-2. DOI: https://doi.org/10.1186/s13018-023-03558-2
Rundgren J, Bojan A, Mellstrand Navarro C, Enocson A. Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national Swedish fracture register. BMC Musculoskelet Disord 2020; 21(1): 88. doi: 10.1186/s12891-020-3097-8. DOI: https://doi.org/10.1186/s12891-020-3097-8
Bergdahl C, Ekholm C, Wennergren D, Nilsson F, Moller M. Epidemiology and patho-anatomical pattern of 2,011 humeral fractures: data from the Swedish Fracture Register. BMC Musculoskelet Disord 2016; 17:159. doi: 10.1186/s12891-016-1009-8. DOI: https://doi.org/10.1186/s12891-016-1009-8
Johansen A, Grose C, Havelock W. Hip fractures in the winter: using the National Hip Fracture Database to examine seasonal variation in incidence and mortality. Injury 2020; 51(4): 1011-14. doi: 10.1016/j.injury.2020.02.088. DOI: https://doi.org/10.1016/j.injury.2020.02.088
Hoff M, Torvik I A, Schei B. Forearm fractures in Central Norway, 1999–2012: incidence, time trends, and seasonal variation. Arch Osteoporos 2016; 11: 7. doi: 10.1007/s11657-016-0257-4. DOI: https://doi.org/10.1007/s11657-016-0257-4
Bergdahl C, Nilsson F, Wennergren D, Ekholm C, Moller M. Completeness in the Swedish Fracture Register and the Swedish National Patient Register: an assessment of humeral fracture registrations. Clin Epidemiol 2021; 13: 325-33. doi: 10.2147/CLEP.S307762. DOI: https://doi.org/10.2147/CLEP.S307762
Moller M, Wolf O, Bergdahl C, Mukka S, Rydberg E M, Hailer N P, et al. The Swedish Fracture Register: ten years of experience and 600,000 fractures collected in a National Quality Register. BMC Musculoskelet Disord 2022; 23(1): 141. doi: 10.1186/s12891-022-05062-w. DOI: https://doi.org/10.1186/s12891-022-05062-w
Wennergren D, Ekholm C, Sandelin A, Moller M. The Swedish fracture register: 103,000 fractures registered. BMC Musculoskelet Disord 2015; 16: 338. doi: 10.1186/s12891-015-0795-8. DOI: https://doi.org/10.1186/s12891-015-0795-8
Marsh J L, Slongo T F, Agel J, Broderick J S, Creevey W, DeCoster T A, et al. Fracture and dislocation classification compendium – 2007: Orthopaedic Trauma Association classification, database and outcomes committee. J Orthop Trauma 2007; 21(10 Suppl): S1-S133. doi: 10.1097/00005131-200711101-00001. DOI: https://doi.org/10.1097/00005131-200711101-00001
Wennergren D, Stjernstrom S, Moller M, Sundfeldt M, Ekholm C. Validity of humerus fracture classification in the Swedish fracture register. BMC Musculoskelet Disord 2017; 18(1): 251. doi: 10.1186/s12891-017-1612-3. DOI: https://doi.org/10.1186/s12891-017-1612-3
Wennergren D, Ekholm C, Sundfeldt M, Karlsson J, Bhandari M, Moller M. High reliability in classification of tibia fractures in the Swedish Fracture Register. Injury 2016; 47(2): 478-82. doi: 10.1016/j.injury.2015.11.002. DOI: https://doi.org/10.1016/j.injury.2015.11.002
Juto H, Moller M, Wennergren D, Edin K, Apelqvist I, Morberg P. Substantial accuracy of fracture classification in the Swedish Fracture Register: evaluation of AO/OTA-classification in 152 ankle fractures. Injury 2016; 47(11): 2579-83. doi: 10.1016/j.injury.2016.05.028. DOI: https://doi.org/10.1016/j.injury.2016.05.028
Giladi A M, Shauver M J, Ho A, Zhong L, Kim H M, Chung K C. Variation in the incidence of distal radius fractures in the U.S. elderly as related to slippery weather conditions. Plast Reconstr Surg 2014; 133(2): 321-32. doi: 10.1097/01.prs.0000436796.74305.38. DOI: https://doi.org/10.1097/01.prs.0000436796.74305.38
Smith R W, Nelson D R. Fractures and other injuries from falls after an ice storm. Am J Emerg Med 1998; 16(1): 52-5. doi: 10.1016/s0735-6757(98)90065-1. DOI: https://doi.org/10.1016/S0735-6757(98)90065-1
Vergouwen M, Samuel T L, Sayre E C, White N J. FROST: factors predicting orthopaedic trauma volumes. Injury 2021; 52(10): 2871-8. doi: 10.1016/j.injury.2021.02.076. DOI: https://doi.org/10.1016/j.injury.2021.02.076
Mattisson L, Bojan A, Enocson A. Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures: data from the Swedish fracture register. BMC Musculoskelet Disord 2018; 19(1): 369. doi: 10.1186/s12891-018-2276-3. DOI: https://doi.org/10.1186/s12891-018-2276-3
Hailer Y D, Mellstrom S, Bruggemann A, Wolf O. Fracture distribution in alpine skiing: a national population based study of 7,110 fractures in adults and children from the Swedish fracture register. Injury 2024; 55(11): 111797. doi: 10.1016/j.injury.2024.111797. DOI: https://doi.org/10.1016/j.injury.2024.111797
Hernefalk B, Bruggemann A, Wolf O. Fracture distribution in electric scooter accidents: a nationwide observational cohort study of 1,874 fractures from the Swedish fracture register. J Orthop Surg Res 2024; 19(1): 448. doi: 10.1186/s13018-024-04940-4. DOI: https://doi.org/10.1186/s13018-024-04940-4
Josefsson S, Bruggemann A, Wolf O, Bogl H P. Fracture patterns in bicycle accidents: a descriptive national cohort study of fractures sustained in bicycle accidents in the Swedish Fracture Register 2015–2022. Injury 2024; 55(12): 111960. doi: 10.1016/j.injury.2024.111960. DOI: https://doi.org/10.1016/j.injury.2024.111960
Bergh C, Wennergren D, Moller M, Brisby H. Fracture incidence in adults in relation to age and gender: a study of 27,169 fractures in the Swedish Fracture Register in a well-defined catchment area. PLoS One 2020; 15(12): e0244291. doi: 10.1371/journal.pone.0244291. DOI: https://doi.org/10.1371/journal.pone.0244291
Bonander C, Holmberg R. Estimating the effects of a studded footwear subsidy program on pedestrian falls among older adults in Gothenburg, Sweden. Accid Anal Prev 2019; 132: 105282. doi: 10.1016/j.aap.2019.105282. DOI: https://doi.org/10.1016/j.aap.2019.105282
Knutsson S B, Wennergren D, Bojan A, Ekelund J, Moller M. Femoral fracture classification in the Swedish Fracture Register: a validity study. BMC Musculoskelet Disord 2019; 20(1): 197. doi: 10.1186/s12891-019-2579-z. DOI: https://doi.org/10.1186/s12891-019-2579-z
Additional Files
Published
How to Cite
License
Copyright (c) 2025 Henrik Ivdal, Linnea Bergenholtz, Carl Bergdahl, Olof Wolf, Emilia Möller Rydberg
This work is licensed under a Creative Commons Attribution 4.0 International License.
