# Slippery Consequences: An Eight-Year Review of Temporary Ice Rink-Related Hand and Wrist Injuries at a Major Trauma Centre

## TL;DR

This study examines hand and wrist injuries from temporary ice rinks over eight years, finding that wrist fractures are common and often require surgery.

## Contribution

The study provides long-term data on the burden and management of ice rink-related injuries at a trauma center.

## Key findings

- Distal radius fractures were the most common injury, affecting 67.5% of cases.
- Injury incidence dropped during the pandemic but increased again afterward.
- Most patients required imaging, and 12% needed surgical intervention.

## Abstract

Introduction

Temporary ice rinks are popular seasonal attractions but pose significant risks of injuries due to variable surface conditions, high user density, and limited safety infrastructure. Distal radius fractures are well recognised in this context, yet long-term data describing their burden and management remain limited. This study aimed to characterise injury patterns and assess their impact on imaging, management, and surgical workload.

Methods

A retrospective review of a prospectively maintained database was conducted at a major trauma centre in the United Kingdom, covering temporary ice-skating seasons from 2017 to 2024. All patients aged 18 years or over who sustained hand and wrist injuries attributable to ice-skating activities were included; patients under 18 years were excluded. Data were extracted from the virtual fracture clinic database. Descriptive statistics summarised demographics, injury patterns, imaging use, and management. Temporal trends were evaluated using Poisson regression, comparing pre-pandemic (2017-2019), pandemic (2020), and post-pandemic (2021-2024) seasons.

Results

A total of 117 patients met the inclusion criteria, comprising 97 females (82.9%) and 20 males (17.1%), with a mean age of 40 ± 15 years (range 18-74). Of these, 105 patients sustained 120 radiographically confirmed bony injuries, most commonly distal radius fractures (n = 81, 67.5%). Other injuries included ulnar (n = 11), radial shaft (n = 7), carpal bones (n = 13), phalanges (n = 5), and metacarpals (n = 3). Twelve patients (10.3%) had isolated soft-tissue injuries. Fourteen patients (12%) required surgery, predominantly open reduction and internal fixation of distal radius fractures. Annual case numbers declined sharply during the 2020 season (IRR = 0.19, 95% CI 0.06-0.58, p = 0.004) but rebounded post-pandemic. The mean injury incidence was ~1.7 per 10,000 skating visits per season.

Conclusions

Temporary ice rink-related hand and wrist injuries represent a recurrent seasonal burden on trauma services, with distal radius fractures comprising the majority of cases and frequently requiring surgery. These findings highlight the importance of preventive strategies, including public education, the promotion of protective equipment, and enhancement of rink safety standards.