Accidents and injuries related to paragliding on mount Babadag, Turkey: A cross-sectional study.

OBJECTIVES: In light of the growing popularity of paragliding, this cross-sectional study aimed to investigate the epidemiology of paragliding accidents, providing insights into the types and severity of injuries sustained as well as the body regions most commonly affected. METHODS: This cross-sectional retrospective study utilized data on adverse paragliding events on Mount Babadag in Turkey, collected by the Mugla Sports Tourism Board (STB) between January 2020 and December 2021, with data sources including out-of-hospital STB forms and in-hospital electronic health records. RESULTS: Out of 241,420 paragliding flights, a total of 44 accidents were identified, with only three resulting in fatalities. Most of the accidents occurred during take off and landing, but the deadliest phase was during flight. The majority of accidents were of low severity, with a median National Advisory Committee for Aeronautics score of 1 (interquartile range [IQR] 1-3) and a median injury severity score of 1 (IQR 1-7.75). The lower limb was the most commonly injured body part, accounting for 55.8% of injuries, followed by the upper limb at 30.8%. CONCLUSIONS: Despite being considered an extreme sport, paragliding carries a relatively low risk of accidents and serious injuries, owing to advancements in training, equipment inspection, and protective gear.

Catastrophic Propeller Brain Injury with Large Scalp Defect Treated with Omental Flap.

In this study, we report a case of catastrophic propeller brain injury with large scalp defect treated with omental flap reconstruction. A 62-year-old man was accidentally caught in a powered paraglider propeller during maintenance. The rotor blades impacted the left part of his head. On arrival at the hospital, he presented with a Glasgow Coma Scale score of E4V1M4. On some areas on his head, skin was noticeably cut off, and the brain tissue out-slipped through an open skull fracture. Continuous bleeding from the superior sagittal sinus (SSS) and the brain surface was observed during emergency surgery. Massive bleeding from the SSS was controlled using a number of tenting sutures and hemostatic agents. We evacuated the crushed brain tissue and coagulated the severed middle cerebral arteries. Dural plasty using the deep fascia of the thigh was performed. The skin defect was closed using an artificial dermis. The administration of high-dose antibiotics has failed to prevent meningitis. Moreover, the severed skin edges and fasciae were necrotic. Plastic surgeons performed debridement and vacuum-assisted closure therapy to promote wound healing. Follow-up head computed tomography revealed hydrocephalus. Lumbar drainage was performed; however, sinking skin flap syndrome was observed. After removing the lumbar drainage, cerebrospinal fluid leakage occurred. We then performed cranioplasty with a titanium mesh and omental flap on day 31. After the surgery, perfect wound healing and infection control were achieved; however, severe disturbance of consciousness remained. The patient was transferred to a nursing home. Primary hemostasis and infection control are mandatory. An omental flap has been determined to be effective in controlling infection by covering the exposed brain tissue.

Foot-Launched Flying Sport Fatalities in the Canton of Berne, Switzerland.

INTRODUCTION: Foot-launched flying sports such as paragliding, hang gliding, and speedflying are popular recreational activities that all pose a significant risk of accidents resulting in injuries or fatalities. We describe the epidemiology, incident circumstances, and findings of forensic examinations of fatalities in these sports. METHODS: In this retrospective analysis, we analyzed different parameters of paragliding, hang gliding, and speedflying fatalities in the canton of Berne, Switzerland, between 2000 and 2018. The data sources were police reports, forensic medical reports, the Swiss Hang Gliding Association, and the Swiss Council for Accident Prevention. RESULTS: In the given period, 40 incidents resulting in 42 fatalities were recorded (2 incidents involved 2-seaters). Three of the 40 incidents did not fulfill the inclusion criteria and were excluded. The deadliest phase was midflight. Collapse of the glider (n=9; 36%) was the leading cause of accidents among paraglider pilots. Multiple trauma (n=21; 54%) was the most frequent cause of death. In the forensic examination, all deaths (n=39) were assessed as accidents. CONCLUSIONS: The different categories of foot-launched flying sports varied in the causes of accidents and deaths. Fatalities in speedflying involved young pilots exposing themselves to high-risk situations. Fatalities may be prevented by enhancing education and training and promoting a cautious attitude among pilots.

Sequential traumatic cervical fractures after paragliding accidents - A case report and literature review.

BACKGROUND: Sports related cervical spine trauma may range from minor injuries to severe life-threatening fractures with spinal cord injuries as following paragliding accidents. CASE DESCRIPTION: A 52-year-old male sustained C4-C5 and C6-C7 fracture-dislocations (American Spinal Injury Association-D) attributed to a paragliding accident. He underwent a C5 corpectomy with C4-C6 anterior fusion. Three years later, he again sustained a paragliding accident, now resulting in a C6-C7 fracture-dislocation that required a C6-C7 anterior discectomy fusion. However, when this latter fusion "failed" 1 month later, he subsequently required a 360° fusion performed as a two-stage procedure. Further, 2 years later, he was involved in a motor vehicle accident resulting in an odontoid fracture. CONCLUSION: Unstable spinal fractures require surgical fixation to prevent neurological injury. Long cervical fusions create lever arms that increase the stress to adjacent levels, rendering them prone to future injury.

Epidemiology and injury patterns of aerial sports in Switzerland.

BACKGROUND: Airborne sports have become more popular in recent years. The number of accidents has increased linearly as athletes take increasingly greater risks to experience the adventurous spirit of this kind of sports. AIM: To investigate the variety of injuries in airborne sport accidents, as well as which acute treatment these patients receive, both before and after admission to a level-one-trauma center. METHODS: We performed a retrospective chart analysis at a major level-one-trauma center in Switzerland for 235-patients who were admitted following airborne sports injuries between 2010 and 2017. Patients' demographic data, injury patterns, emergency primary care procedures and intra-hospital care were recorded. RESULTS: Overall, 718-injuries in 235-patients were identified; the spine was the most commonly affected region with 46.5% of injuries (n = 334/718) in 143-patients. In 69-patients (15.5%), the (non-spine) thorax was affected, followed by the lower and upper extremity, pelvis, head/face and abdominal injuries. Eleven-patients had to be intubated at the trauma site. Three patients were resuscitated after onset of pulseless-electrical-activity. Two-patients died in the resuscitation room. In 116-cases, surgery was indicated including 55-emergency surgeries. Another 19 patients (8.1%) were transferred to the intensive care unit. CONCLUSION: Paragliders are most commonly affected, although the highest injury severities were identified for Building, Antenna, Span and Earth-jumping athletes. First responders, treating physicians and pilots should be aware of the risk for potentially serious and life-threatening injury with an in-hospital mortality of 0.9%.

Spinopelvic dissociation in patients suffering injuries from airborne sports.

BACKGROUND: Spinopelvic dissociation which is also called U-type or referred to H-type sacral fractures with a transverse fracture line is an infrequent injury that results mainly from high-energy accidents. This results in an osseous dissociation of the upper central segment of the sacrum and the entire spine from the lower sacral segments. The purpose was to investigate the incidence of spinopelvic fracture in general among airborne injuries. PATIENTS AND METHODS: Using our electronic patient records, we retrospectively investigated all sacral fractures related to airborne sports between 2010 and 2017. All injuries were classified according to the Roy-Camille, Denis, AOSpine and the Tile classification system. RESULTS: During the period of interest, 44 patients (18.7%) were admitted with sacral fractures after accidents obtained from airborne sports, including 16 spinopelvic dissociations (36.4%). The majority of these injuries were obtained from paragliding (75.0%), followed by BASE jumping (21.4%) and parachuting (4%). The mean injury severity score (ISS) in the spinopelvic dissociation group was significantly higher compared with other sacral fracture group (38.1 vs. 20.0; p < 0.001). Six lambda-type, four T-type, four H-type and two U-type injuries were identified. In total, four patients (25%) were found to have neurological impairment. For treatment, 87.5% of patients underwent subsequent surgical stabilization. CONCLUSION: Airborne sports have high potential for serious, life-threatening injuries with a high incidence of spinopelvic dissociation. In the literature, the prevalence of spinopelvic dissociation in sacral fractures is described to be between 3 and 5%. In our series, the prevalence is 36.4%. It is important to identify the potential injuries promptly for the further treatment. These slides can be retrieved under Electronic Supplementary Material.

Mortality in Different Mountain Sports Activities Primarily Practiced in the Summer Season-A Narrative Review.

Millions of people engage in mountain sports activities worldwide. Although leisure-time physical activity is associated with significant health benefits, mountain sports activities also bear an inherent risk for injury and death. However, death risk may vary across various types of mountain sports activities. Epidemiological data represent an important basis for the development of preventive measures. Therefore, the aim of this review is to compare mortality rates and potential risk factors across different (summer) mountain sports activities. A comprehensive literature search was performed on the death risk (mortality) in mountain sports, primarily practiced during the summer season, i.e., mountain hiking, mountain biking, paragliding, trekking, rock, ice and high-altitude climbing. It was found that the death risk varies considerably between different summer mountain sports. Mortality during hiking, trekking and biking in the mountains was lower compared to that during paragliding, or during rock, ice or high-altitude climbing. Traumatic deaths were more common in activities primarily performed by young adults, whereas the number of deaths resulting from cardiovascular diseases was higher in activities preferred by the elderly such as hiking and trekking. Preventive efforts must consider the diversity of mountain sports activities including differences in risk factors and practitioners and may more particularly focus on high-risk activities and high-risk individuals.

Spinal injuries in airborne accidents: a demographic overview of 148 patients in a level-1 trauma center.

PURPOSE: The purpose of this study was to investigate the type and severity of spinal injury in airborne sports, as well as patients demographics in this unique set of athletes. Paragliding is one of the most popular airborne sports in Switzerland, which thought to be no less dangerous with a high potential for spinal injury. Few studies on spinal column injuries have been performed in these high-risk athletes with only inconsistent findings. METHODS: Patient charts were analyzed for all airborne sports injuries affecting the spine from 2010 to 2017 at a level-1 trauma center in Switzerland. To classify the injuries, we used the newest AOSpine classification, ASIA-grading and the injury severity score (ISS). In total, 235 patients were admitted to the emergency department due to an airborne injury. A total of 148 patients (148/235, 63.0%) which were predominantly male (125/235, 84.5%) at a mean age of 39.4 years suffered 334 spinal fractures and 5 spinal contusions. The mean ISS was 17.3, and the L1 vertebra was most commonly affected (47.6% of cases, 68/148). RESULTS: A total of 78 patients (54.5% or 78/148) required spine surgery due to instability or neurological deficits (31/148 patients; 20.9%). Concomitant injuries were identified in 64.2% of cases (n = 95). CONCLUSION: Due to the increasing popularity of airborne sports, age of patients and severity of injuries (ISS) increased compared with the literature. The thoracolumbal spine is at especially high risk. To prevent further complications, the treatment procedure has to be sought carefully and algorithm should be introduced in clinics to avoid delay in diagnostics and surgery. LEVEL OF EVIDENCE: III, retrospective comparative study. These slides can be retrieved under Electronic Supplementary Material.

Acute Effect of Extreme Sports on Serum Lipids.

PURPOSE: The aim of this study is to determine the effect of rafting and paragliding exercises by sedentary males on serum lipids. MATERIAL AND METHODS: 17 male rafters and 10 male paragliders volunteers (non-smoker, no known history of cardiovascular disease, body mass index <25 kg/m2, and no intake of prescription medications) participated in the study. Participants had blood samples taken a day before and after rafting and paragliding practices. Data were analyzed by Wilcoxon and Mann-Whitney U tests. RESULTS: Significant decreases occurred for the low-density lipoprotein (LDL)/very low-density lipoprotein (VLDL) ratio in the rafting group after the exercise; though, there was no significant difference in serum lipids parameters of the paraglide group after the exercise. CONCLUSION: While acute rafting and paragliding exercises have similar effects on TG and HDL, effect on LDL/VLDL ratio is different.

The Physiology of Paragliding Flight at Moderate and Extreme Altitudes.

Wilkes, Matt, Martin J. MacInnis, Lucy A. Hawkes, Heather Massey, Clare Eglin, and Michael J. Tipton. The physiology of paragliding flight at moderate and extreme altitudes. High Alt Med Biol 19:42-51, 2018.-Paragliding is a form of free flight, with extreme-altitude paragliding being an emerging discipline. We aimed to describe the physiological demands and the impact of environmental stressors of paragliding at moderate and extreme altitudes. We recorded oxygen consumption (VO2), heart rate (HR), respiratory frequency (fR), tidal volume (VT), oxygen saturation, accelerometry (G), and altitude in 9.3 hours of flight at moderate altitudes (to 3073 m, n = 4), 19.3 hours at extreme altitude (to 7458 m, n = 2), and during high-G maneuvers (n = 2). We also analyzed HR data from an additional 17 pilots (138 hours) using the Flymaster Live database to corroborate our findings. All pilots were male. Overall energy expenditure at moderate altitude was low [1.7 (0.6) metabolic equivalents], but physiological parameters were notably higher during takeoff (p < 0.05). Pilots transiently reached ∼7 G during maneuvers. Mean HR at extreme altitude [112 (14) bpm] was elevated compared to moderate altitude [98 (15) bpm, p = 0.048]. Differences in pilots' VT and fR at moderate and extreme altitudes were not statistically significant (p = 0.96 and p = 0.058, respectively). Thus, we conclude that physical exertion in paragliding is low, suggesting that any subjective fatigue felt by pilots is likely to be cognitive or environmental. Future research should focus on reducing mental workload, enhancing cognitive function, and improving environmental protection.

AORTIC INJURY DUE TO PARAGLIDING: A CASE REPORT.

A 64-year-old male fell from an altitude of 10 m while paragliding after stalling due to the wind. The purpose of this case report is to describe the outcomes after multiple injuries sustained during a paragliding accident, including a potentially life-threating injury to the thoracic aorta. The subject sustained a bite wound on his tongue, injuries to his chest (left side) and back, and a right forearm deformity. Enhanced whole body computed tomography (CT) revealed fractures of the bilateral laminae of the second and third cervical bones, right first rib, the tenth thoracic vertebral body (compression type), second lumbar vertebral body (burst type) and the right radius, Other injuries included an injury to the thoracic aortic arch and the presence of intraabdominal fluid collection without perforation of the digestive tract. Endovascular treatment was selected for the aortic injury because of multiple injuries. Immediate management included hypotensive rate control therapy using calcium and a beta blocker. On the fourth hospital day, the subject underwent deployment of a stent-graft to the aorta and subsequent surgical immobilization for the lumbar burst fracture. He also underwent surgical immobilization of the radial fracture and was discharged on the 28th hospital day. First responders or physicians should consider the possibility of aortic injury when treating patients who suffer falls while paragliding and provide appropriate management. Failure to provide appropriate management of an aortic injury could result in death. LEVEL OF EVIDENCE: 4.

Characteristics of injuries caused by paragliding accidents: A cross-sectional study.

BACKGROUND: This study was undertaken to analyze the characteristics and risk factors relating to fatalities and injuries caused by paragliding. METHODS: The judicial examination reports and hospital documents of 82 patients traumatized in 64 accidents during 242 355 paragliding jumps between August 2004 and September 2011 were analyzed. RESULTS: In these accidents, 18 of the 82 patients lost their lives. In the patients with a confirmed cause of accident, most of them were involved with multiple fractures and internal organ injuries (n=8, 44.4%). CONCLUSION: We investigated the incidence of paragliding injuries, the types of the injuries, and the severity of affected anatomical regions. The findings are significant for the prevention of paragliding injuries and future research.

Accidents and injuries related to powered paragliding: a cross-sectional study.

OBJECTIVES: Powered paragliding (PPG) and paragliding are two totally different sports, mainly because of the use of an engine in powered paragliding. As a consequence, the pattern of injuries caused by each of these two sports may be different. SETTING: To test this hypothesis, we analysed 384 incident reports gathered by the US Powered Paragliding Association from 1995 to 2012. The majority of the incidents occurred in the USA, while 26 incidents occurred elsewhere: Canada (8), Mexico (5), Panama (1), China (1), Japan (1), Malaysia (1), Indonesia (Java) (1), Europe (8): of which Spain (1), Belgium (1), UK (3), Italy (1), Romania (1), unknown (1). OUTCOME: To identify the most affected body area and the most common type of injury sustained in PPG, and to highlight any differences from paragliding. RESULTS: The most affected body areas in PPG were the upper limbs (44.5%), followed by the lower limbs (32%), the back (9.8%), the head (7%), the pelvis (3.1), the chest (2.7%) and the abdomen (0.7%) (p<0.001). The engine caused 43 accidents (11.2%) in our study and was responsible for the majority of injuries to the upper limbs. The number of fatal accidents in PPG is not lower than in paragliding and hang-gliding. CONCLUSIONS: To help prevent the specific injuries of PPG, the most appropriate equipment should be identified. The results of this study also suggest that, in the future, this sport should be analysed separately from paragliding.

Práticas aventureiras e situações de risco no voo livre: uma análise a partir do conceito de redoma sensorial / Adventurous practices and risk situations in the free flight: an analysis starting from the concept of sensorial dome

O presente estudo analisa situações de risco na prática de voo livre por intermédio do conceito de redoma sensorial. A amostra foi constituída de 19 (dezenove) praticantes da modalidade de parapente, com média de idade de 31 (trinta e um) anos, considerou-se o desvio padrão com significância > < 0,05%. A partir do método de estudo descritivo-exploratório foi possível verificar que o domínio da técnica e o uso de equipamentos adequados, apesar de imprescindíveis não garantem o êxito desses atores. Muitas vezes, as situações de risco vivenciadas agregam num primeiro momento um verdadeiro arcabouço de elementos sensoriais extraordinários. No entanto, as vivências diárias numa dada modalidade podem levar à banalização desses elementos por parte do praticante, transformando-se em elementos sensoriais ordinários. Essa situação poderá implicar negativamente na prática das modalidades de esporte de aventura como, por exemplo, a manutenção da integridade física e emocional do praticante.

This study analyzes the risk situations in the practice of free flight through the concept of sensorial dome. The sample consisted of 19 (nineteen) practitioners of the paragliding, with the age middle was 31 (thirty one) years old and the arithmetic absolute media considered by researches was > < 0.05%. From the method of descriptive exploratory study was concluded that that the field of technology and use appropriate equipment, though not essential guarantee the success of these actors. In the major of time, the risky situations experienced in the adventure sport, join at a first moment a true outline of extraordinary sensorial elements. However, the daily experiences observed in a given kind can take to the banalization of those elements by the apprentice, becoming ordinary sensorial elements. Such change can present implications in and for the practice of the adventure sport kinds in natural environment like, for instance, the apprentice's physical and emotional integrity.