A study authored by trauma surgeons at Dartmouth-Hitchcock Medical Center has found that serious head injuries actually went up with ski helmet use.

The surgeons wanted to know if wearing ski helmets help to prevent traumatic injury. So they investigated the relationship between helmet use, injury types, and injury severity among skiers and snowboarders with and without helmets.

The results were surprising. Over the course of the study, seven hundred twenty-one patients (65% helmeted, 35% unhelmeted) met inclusion criteria. Though helmet use doubled during the study period (43% to 81%), the rate of any head injury did not significantly change (49% to 43%). On multivariable regression, helmeted patients were significantly more likely to suffer severe injury. this included intracranial hemorrhage, chest injury, and/or lumbosacral spine injury than unhelmeted patients.

However, helmeted patients were half as likely to suffer cervical spine injury and a third as likely to sustain skull fracture and/or scalp laceration.

Their conclusion is that helmeted skiers and snowboarders evaluated at a Level I trauma center were more likely to suffer severe injury, including intracranial hemorrhage, as compared with unhelmeted participants. However, they were less likely to sustain skull fractures or cervical spine injuries.

One of the authors of the Study Dr. Andrew Crockett, told Vermont Public Radio, “The ‘why’ is a tough tough question to answer. Just looking at our numbers and anecdotally, the best solution is just that despite the use of helmets, in the patients that we’ve seen at our facility, they’ve received so much traumatic energy that the helmets hasn’t proven to be as effective as we would like.”

“Perhaps patients who are getting into these major traumas and ending up in our center who are helmeted, perhaps they have a false sense of security when they’re wearing a helmet and they’re skiing more recklessly or outside of their capabilities.” Dr. Eleah Porter

Both Dr. Porter and Dr. Crockett still endorse helmet use but would like to remind first responders not to assume that a helmeted individual has not sustained a serious head injury.