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The severity of the reported kiteboarding injuries varied from minor lacerations to severe multitrauma. Injury severity is only sparsely described in other papers on kiteboarding, making comparisons difficult. The AIS scores for the injuries described here, where more than half resulted in moderate to severe injuries, demonstrates the possibility for harm for kiteboarders.
The proportion of cerebral concussions was in accordance with three previous studies on snow and water [1, 5, 14]. However, compared with these three reports, we also found a high number of fractures. Other high-risk sports reporting extremity fractures and cerebral concussion as the most common injuries are paragliding and hang-gliding [15, 16]. However, unlike paragliding and hang-gliding, where spinal injuries are also common, this study included only two spine fractures. This discrepancy might be due to the comparatively lower altitudes typically involved in kiting jumps.
The median ISS score was 12 in accidents resulting from falls from 5 m or more, indicating the most severe mechanism of injury in our data. However, one of the multitrauma cases with an ISS score of 17 was caused by a collision, and another injury had an ISS score of 14 after a fall from less than 5 m. Hence, life-threatening injuries may occur from kiteboarding accidents by different mechanisms of injury. When treating patients experiencing a kiteboarding accident, the many mechanisms of injury possible in kiteboarding accidents should be kept in mind. Severe injuries occurred both on snow and on water. ISS was scored retrospectively and does not necessarily reflect threats to life in the individual accident. Obviously, an injury occurring on water may be an immediate threat to life, especially if a kitesurfer is not wearing a life vest.
Although 94% used a helmet on snow, only 33% used a helmet on water. Nevertheless, helmet use was more frequent than an earlier study reporting only 4%, by van Bergen et al. in 2020 [14]. Only 2 of the 12 cerebral concussions in our study occurred on water, but there is a risk of head injuries from boards, other kiteboarders, rocks, obstacles, and falls from heights in kitesurfing. The use of helmets should be emphasised. We report one kitesurfer experiencing a nonfatal drowning and another rescued by the Air Ambulance while being pulled offshore by the wind. None of these kitesurfers wore a life vest, and only four out of 14 of the injured kiteboarders used a life vest. This low use of a life vest is in accordance with an article from 2005 showing that none of the 30 rescued kiteboarders in Cape Town wore a life vest [8].
We found a higher proportion of injured athletes who attended a kiteboarding course prior to the accident (52%) compared with an Austrian study (17.5%) [5]. One-third of the accidents occurred when the wind speed was more than 10 m/s. Moroder et al. found 18.2% [5]. These results demonstrate that many accidents occur during low wind speeds. Moroder et al. also proposed the onset of a sudden wind gust as a contributing cause of accidents, as reported in our study. Increased knowledge on wind patterns acquired during a kiteboarding course may help to avoid accidents resulting from wind gusts. Operator error, lack of experience, and wind conditions have been described previously as the most common reasons for kiteboarding accidents [5, 14]. In contrast, we found no difference in injury severity related to experience level. Nevertheless, in our study, four out of five participants cited operator errors or lack of experience as a contributing factor to the accident. Experience in this activity could indeed play a key role in avoiding accidents.
A recall bias may be present in our retrospective design, especially regarding data on weather conditions and the estimated preexposure time. Although the accidents happened some years ago, the data collection and interviews were performed in 2015. The injury severity was scored by one of the authors and, in some cases, based on information provided retrospectively by patients and their knowledge and understanding of their injury. This might have led to an under- or overestimation of NACA and ISS scores. The reported causes of the accidents and estimation of the wind strengths were based on the kiteboarders subjective assumptions, which can be difficult to state accurately. The snowball sampling method has limitations in identifying accidents because an unknown proportion of kiteboarders are members of a kiteboarding club, and no licence or a registered course is mandatory before performing the sport. It is likely that the method more readily identified the most severe injuries, potentially leading to the omission of some minor injuries in the reporting. This discrepancy might have distorted the central data, portraying the distribution of injury severity as being higher than it was. A selection bias might exist due to the likelihood of more active and experienced athletes being drawn to the study. However, cross-referencing with the air ambulance database has helped mitigate this. It’s possible that participating athletes are more safety-conscious, potentially leading to higher usage of protective gear. Despite limitations as a small descriptive study, this article provides valuable insights into kiteboarding injury patterns and mechanisms.
Due to the low number of accidents identified in our study, the results must be interpreted with caution. However, we would like to emphasise our safety concerns in kiteboarding, illustrated by the risk of severe injuries, the high proportion of head injuries, and the low use of helmet and life vests in kitesurfing. To gather more knowledge about kiting injuries, it’s crucial to improve accident registration. Additional research is warranted concerning the consequences of kite-related injuries, particularly with regards to the level of medical attention required, duration of hospitalization, and the number of days of disability.
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