Binding function in relation to injury risk in downhill skiing

Time-trend studies suggest that in the recent past, the use of modern equipment and adequately functioning ski bindings have had a preventive effect on injuries. The question of whether a further decrease of injury figures can still be expected from better binding adjust ment is investigated in a case-control study (N = 1,148) conducted among Dutch skiers. Nonrelease of both bindings directly before injury was associated with a higher risk (odds ratio = 3.3) for lower extremity (LE) injury. Binding release before LE injury was highest (31 %) among those for whom adjustment was per formed and then confirmed with a test device. The proportion of nonrelease is highest for knee injuries. No effect on injury risk could be found for the time of adjustment, the method of adjustment, or the person performing the adjustment. Direct measurement of binding function seems indispensable. The use of rented or borrowed skis was associated with a higher risk (odds ratio = 1.9) for LE injury. The same holds for ignorance concerning the type of ski and the age of the skis and bindings. We concluded that binding adjust ment still seems to be a risk factor open to manipula tion. The efficacy of intervention aimed at better ad justment should be studied experimentally.