RT Journal Article SR Electronic T1 Head injury mechanisms in FIS World Cup alpine and freestyle skiers and snowboarders JF British Journal of Sports Medicine JO Br J Sports Med FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine SP 61 OP 69 DO 10.1136/bjsports-2017-098240 VO 52 IS 1 A1 Sophie Elspeth Steenstrup A1 Arnhild Bakken A1 Tone Bere A1 Declan Alexander Patton A1 Roald Bahr YR 2018 UL http://bjsm.bmj.com/content/52/1/61.abstract AB Introduction Head injuries represent a concern in skiing and snowboarding, with traumatic brain injuries being the most common cause of death.Aim To describe the mechanisms of head and face injuries among World Cup alpine and freestyle skiers and snowboarders.Methods We performed a qualitative analysis of videos obtained of head and face injuries reported through the International Ski Federation Injury Surveillance System during 10 World Cup seasons (2006–2016). We analysed 57 head impact injury videos (alpine n=29, snowboard n=13, freestyle n=15), first independently and subsequently in a consensus meeting.Results During the crash sequence, most athletes (84%) impacted the snow with the skis or board first, followed by the upper or lower extremities, buttocks/pelvis, back and, finally, the head. Alpine skiers had sideways (45%) and backwards pitching falls (35%), with impacts to the rear (38%) and side (35%) of the helmet. Freestyle skiers and snowboarders had backwards pitching falls (snowboard 77%, freestyle 53%), mainly with impacts to the rear of the helmet (snowboard 69%, freestyle 40%). There were three helmet ejections among alpine skiers (10% of cases), and 41% of alpine skiing injuries occurred due to inappropriate gate contact prior to falling. Athletes had one (47%) or two (28%) head impacts, and the first impact was the most severe (71%). Head impacts were mainly on snow (83%) on a downward slope (63%).Conclusion This study has identified several characteristics of the mechanisms of head injuries, which may be addressed to reduce risk.