Background: Sledding is a popular and seeming innocuous winter sport, but we hypothesize that sled injuries are much like bicycle injuries. Current literature supports helmet usage in other winter sports, but little information can be found to clarify the use of helmets in sledding. The objectives of the study are to assess the injury patterns of sled riders and clarify the need for helmet usage and to locate specific geographic catchments in which resources can be better focused.

Methods: After Institutional Review Board approval, the registry of a Level I pediatric trauma center was evaluated from 2000 to 2005. Information regarding unhelmeted bicyclists and sled riders was obtained. Injuries involving motorized vehicles were excluded. Demographics, injury patterns, and outcomes were evaluated. Descriptive statistics, Student's t test, and Fisher's exact or χ² analyses were preformed. GIS evaluation was performed using ArcGIS. Statistical significance was defined as p < 0.05.

Results: One hundred thirty-six patients sustained trauma on sleds; 509 patients were injured on bicycles. Head injuries represented the largest percentage of injuries in both groups. Handlebar- or crossbar-related injuries (abdomen and perineum) were more common in the bicycle group. Injuries occurred with equal frequency in urban and rural regions.

Conclusion: We conclude that the injury patterns between sledding and unhelmeted bicycling are similar. Helmet usage is strongly recommended to prevent head injuries to bike riders; therefore, this study supports the routine usage of helmets in sledding and the need for widespread education on helmet usage in both rural and urban regions.