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Malige A, Markiewitz ND, Badrinath R, Baldwin KD, Wells L, Williams BA. Trampolines Versus Playgrounds - A Comparative Assessment of Pediatric Fractures Sustained From Recreational Play. J Am Acad Orthop Surg Glob Res Rev 2024; 8:01979360-202407000-00005. [PMID: 38996208 PMCID: PMC11239173 DOI: 10.5435/jaaosglobal-d-24-00173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 05/16/2024] [Indexed: 07/14/2024]
Abstract
INTRODUCTION Using the Pediatric Health Information System, this study compared the relative severity of fractures sustained from trampolines with those from other playground equipment. METHODS Pediatric patients were identified in the Pediatric Health Information System with trampoline-related injuries (TRIs) or playground-related injuries (PRIs) diagnosed as fractures. Adjustments were made for hospital, year of injury, sex, age, race, median household income, and rurality through propensity score weighting. Four injury-related outcome measures were examined as a proxy for injury severity. RESULTS A total of 133,232 patients met inclusion criteria. In unadjusted univariate analyses, TRIs were associated with greater odds of severe fracture and lower odds of receiving surgical treatment (OR = 0.954) compared with PRIs. After adjustment, TRIs sustained in late childhood and adolescence were more likely to receive surgical management (OR = 1.092 and OR = 1.192, respectively) while TRIs sustained in younger children were less likely (OR = 0.607) than PRIs. DISCUSSION Youths in late childhood and adolescence are at increased odds of undergoing surgical management after trampoline fractures. Beyond underscoring the risks of trampoline play, our results highlight the importance of considering age in recreational injury epidemiology and the public health safety initiatives aimed at specific age groups.
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Affiliation(s)
- Ajith Malige
- From the St. Luke's University Health Network, Bethlehem, PA (Dr. Malige), and the Children's Hospital of Philadelphia, Philadelphia, PA (Dr. Markiewitz, Dr. Badrinath, Dr. Baldwin, Dr. Wells, and Dr. Williams)
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González-Gálvez N, Vaquero-Cristobal R, Maciá-Andreu MJ, García-Tascon M, Soler-Marín A, Gallardo-Guerrero AM. Influence of physical fitness components on personality factors and risk perception of children and adolescents: a cross-sectional study. BMJ Open 2023; 13:e071995. [PMID: 38072471 PMCID: PMC10728990 DOI: 10.1136/bmjopen-2023-071995] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 10/27/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES To examine the associations of cardiorespiratory fitness (VO2 max) and muscular strength with indicators related to the risk scale, such as perceived competence, sensation seeking, competitiveness, risk taking and risk perception in sports. DESIGN Cross-sectional study. SETTING High schools from the Region of Murcia (Spain). PARTICIPANTS Three-hundred-and-seventeen adolescents participated (mean age: 13.69±1.2 years old). PRIMARY AND SECONDARY OUTCOME MEASURES Body mass, body height, Course-Navette test, upper limb strength and psychoeducational factors that determine the propensity towards sports accidents in school children, the Sports Accident Propensity Scale were evaluated. It was performance t-test for independent samples, stepwise multiple linear regression models and a multiple mediation analysis. RESULTS The analysis showed significant differences with respect to sex in height, VO2 max, handgrip strength and in all factors of the questionnaire (p=0.02-<0.01). Adolescents who presented greater VO2 max, strength in the handgrip test and age showed a higher score in factors 1 and 3. Higher scores in factor 2 were associated with better VO2 max and strength in handgrip test. Youngers and better values of strength in the handgrip showed higher score in factors 4 and 5. The mediation analysis with two mediating variables (handgrip strength and VO2 max) showed a significant indirect effect. When handgrip strength and VO2 max were included in the equations, the association between sex and each factor ceased to be significant. CONCLUSION This study highlights the potential benefits of muscular strength (handgrip) and VO2 max in the perceived risk scale, and the variable of age on this. TRIAL REGISTRATION NUMBER Clinical trial: NCT05544370 (pre-results).
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Affiliation(s)
- Noelia González-Gálvez
- Facultad de Deporte, UCAM Universidad Católica de Murcia, Murcia, Región de Murcia, Spain
| | - Raquel Vaquero-Cristobal
- Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Murcia, Murcia, Región de Murcia, Spain
| | | | - Marta García-Tascon
- Departamento del Deporte e Informática, Pablo de Olavide University, Sevilla, Andalucía, Spain
| | - Antonio Soler-Marín
- Dpto. Tecnología de la Alimentación y Nutrición, UCAM Universidad Católica de Murcia, Murcia, Región de Murcia, Spain
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Husen M, Engrav SK, Saul D, Stuart MJ, Milbrandt TA, Levy BA, Krych AJ, Saris DB. Differences in Trampoline-Related Knee Injuries Between Children and Adults: A Cross-Sectional Study. Orthop J Sports Med 2023; 11:23259671231209666. [PMID: 37954864 PMCID: PMC10637177 DOI: 10.1177/23259671231209666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/07/2023] [Indexed: 11/14/2023] Open
Abstract
Background Little is known about the specific risk of knee injuries due to trampoline accidents in adults compared with children. Purpose To investigate the differences in trampoline-related knee injuries between children and adults and identify risk factors and protective strategies to reduce injury incidence. Study Design Cross-sectional study; Level of evidence, 3. Methods Data on 229 consecutive patients treated for trampoline-related knee injuries in a single institution were prospectively collected, analyzed, and included. Risk factors, injury patterns, and clinical treatments were compared between skeletally immature and skeletally mature patients. Logistic regression was used to determine the odds ratios for specific risk factors for trampoline-related injuries-including body mass index (BMI), trauma mechanism, patient age, and accident location. Results A total of 229 patients met the inclusion criteria; 118 (52%) patients (women, 54.2%; mean age, 8.5 ± 4.1 years) were skeletally immature at the time of injury, and 111 (48%) patients (women, 72%; mean age, 31.9 ± 13.1 years) had closed physes on initial presentation and were classified as skeletally mature. A total of 63 patients (28%) required surgical treatment for their knee injury. Overall, 50 anterior cruciate ligament (ACL) tears, 46 fractures, 39 meniscal tears, 31 ligamentous tears other than ACL, 22 patellar dislocations, and 38 soft tissue injuries, such as lacerations, were recorded. Skeletally mature patients had 7.8 times higher odds (95% CI, 1.6-46.8; P < .05) and 19.1 increased odds (95% CI, 5.5-74.9; P < .05) of an ACL tear or another ligamentous tear, respectively, compared with skeletally immature patients. Patients who described instability and giving way of the knee as relevant trauma mechanisms had odds of 3.11 (95% CI, 0.9-14.8; P < .05) of an ACL tear compared with other trauma mechanisms. Meniscal tears were observed more frequently in the skeletally mature cohort (P < .05). An elevated BMI was associated with a significantly higher relative risk of an ACL tear, a ligamentous tear other than the ACL, and an injury requiring surgery. A third of surgically treated patients were subject to a delayed diagnosis. Conclusion Adults had a significantly increased risk of ligamentous and meniscal tears and required operative intervention more often than skeletally immature individuals. Elevated BMI, age, and instability events in terms of trauma mechanism conveyed an increased risk of structural damage to the knee.
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Affiliation(s)
- Martin Husen
- Department of Orthopaedic Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Samantha K. Engrav
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Dominik Saul
- Kogod Center on Aging and Division of Endocrinology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael J. Stuart
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Todd A. Milbrandt
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Bruce A. Levy
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Aaron J. Krych
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniël B.F. Saris
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Eager D, Zhou S, Barker R, Catchpoole J, Sharwood LN. A Public Health Review into Two Decades of Domestic Trampoline Injuries in Children within Queensland, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1742. [PMID: 36767107 PMCID: PMC9914378 DOI: 10.3390/ijerph20031742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
Trampolining as an activity brings enjoyment and many health benefits, but at the same time it carries an injury risk. Most domestic trampoline users are children who are developing in skill, cognition, risk perception, physical strength and resilience to injury. Several common patterns of child trampoline injuries have been identified and countermeasures outlined in standards have been taken to reduce higher risk injury mechanisms, such as entrapment and falls from the trampoline through design, product and point of sale labelling. In Australia, the first national trampoline standard was published in 2003 which introduced improvements in trampoline design and requirements for labelling and padding. This work investigated the potential impact of these and subsequent changes based on almost two decades of emergency department trampoline injury data collected in Queensland, Australia. These data describe the changing representative proportion and pattern of trampoline injuries in Queensland over time by age, mechanism, gender, severity and nature of injury of injured persons up to the age of 14 years. The interrelationships between different injury characteristics were also analysed to propose the main factors influencing injury occurrence and severity. These findings seem to indicate that safety evolution in the form of enclosure nets, frame impact attenuation and entrapment protection have likely improved domestic trampoline safety. Other factors, such as adult supervision, minimum age and avoidance of multiple users, could further reduce injury but are harder to influence in the domestic setting.
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Affiliation(s)
- David Eager
- Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney 2007, Australia
| | - Shilei Zhou
- Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney 2007, Australia
| | - Ruth Barker
- Queensland Injury Surveillance Unit, Jamieson Trauma Institute, Royal Brisbane and Women’s Hospital, Herston 4029, Australia
| | - Jesani Catchpoole
- Queensland Injury Surveillance Unit, Jamieson Trauma Institute, Royal Brisbane and Women’s Hospital, Herston 4029, Australia
| | - Lisa N. Sharwood
- Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney 2007, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney 2032, Australia
- Translational Health Collective, Kolling Institute, Clinical School Northern, University of Sydney, Sydney 2006, Australia
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Runtz A, Nallet J, Font V, Anriot M, Pechin C, Langlais J, de Billy B. Trampoline injuries in children: A prospective study. Orthop Traumatol Surg Res 2022; 108:103289. [PMID: 35470113 DOI: 10.1016/j.otsr.2022.103289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Trampolining is popular and widely practiced among children. A literature review has shown a rise in the incidence of trampoline injuries with a concomitant increase in paediatric emergency department visits. The primary objective of this study was to describe the severity of trampoline injuries in children. The secondary objectives were to assess the epidemiology of the study population and injuries and to describe the treatments. HYPOTHESIS We hypothesized that over 10% of trampoline injuries were severe. MATERIAL AND METHODS We prospectively evaluated consecutive patients seen for surgical conditions at our paediatric emergency department over a 10-month period. Among them, 103 (1.2% of visits) aged 4 months to 16 years (mean, 8 years) had trampoline injuries. We classified trampoline injuries as severe if they required general anaesthesia. RESULTS Severe injuries accounted for 16.5% of all trampoline injuries. The upper limb was predominantly affected (70.6% of cases). Overall, 66.7% of fractures were at the upper limb and 76% of contusions at the lower limb. The predominant fracture sites were the supra-condylar humerus (15.3%) and distal radius (15.3%). Among patients with non-severe injuries, four-fifths left the emergency department with a temporary immobilisation system. DISCUSSION The proportion of severe injuries was slightly higher in our study than in earlier reports. Trampoline injuries remain uncommon but can be severe. Thus, in our study over one-sixth of patients required surgery under general anaesthesia. LEVEL OF EVIDENCE IV, prospective descriptive epidemiological study.
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Affiliation(s)
- Adrien Runtz
- Service de chirurgie pédiatrique, CHU Besançon, 25000 Besançon, France.
| | - Jérémie Nallet
- Service de chirurgie pédiatrique, CHU Besançon, 25000 Besançon, France
| | - Victor Font
- Service de chirurgie pédiatrique, CHU Besançon, 25000 Besançon, France
| | - Mathilde Anriot
- Service de chirurgie pédiatrique, CHU Besançon, 25000 Besançon, France
| | - Caroline Pechin
- Service de chirurgie pédiatrique, CHU Besançon, 25000 Besançon, France
| | - Jean Langlais
- Service de chirurgie pédiatrique, CHU Besançon, 25000 Besançon, France
| | - Benoît de Billy
- Service de chirurgie pédiatrique, CHU Besançon, 25000 Besançon, France
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Hussein MH, Toreih AA, Attia AS, Alrowaili M, Fawzy MS, Tatum D, Toraih EA, Kandil E, Duchesne J, Taghavi S. Trampoline Injuries in Children and Adolescents: A Jumping Threat. Pediatr Emerg Care 2022; 38:e894-e899. [PMID: 34339161 DOI: 10.1097/pec.0000000000002457] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE As trampoline use grows more popular in the United States, the frequency of injuries continues to climb. We hypothesized that toddlers would be at the highest risk for trampoline injuries requiring hospitalization. METHODS The National Electronic Injury Surveillance System database was examined for trampoline injuries from 2009 to 2018. Patients were categorized into 3 main age groups: toddlers (<2 years), children (2-12 years), and adolescents (13-18 years). Regression models were used to identify patients at high risk for injury or hospitalization. RESULTS There was a total of 800,969 meeting inclusion criteria, with 433,827 (54.2%) occurring at their own homes and 86,372 (18.1%) at the sporting venue. Of the total, 36,789 (4.6%) were admitted to a hospital. Fractures (N = 270,884, 34%), strain/sprain injuries (N = 264,990, 33%), followed by skin contusions/abrasions (N = 115,708, 14%) were the most common diagnoses. The most frequent injury sites were lower and upper extremities accounting for 329,219 (41.1%) and 244,032 (30.5%), whereas 175,645 (21.9%) had head and neck injuries. Musculoskeletal injuries (74%) and concussions (2.6%) were more frequent in adolescents than children (67.6% and 1.6%) and toddlers (56.3% and 1.3%). Internal organ and soft tissue injuries were frequent in toddlers. There were no fatalities reported in the injured patients. Multivariate analysis showed adolescents, female sex, extremity injuries, and musculoskeletal injuries were associated with hospitalization. Injury at a sporting venue was not associated with hospitalization. CONCLUSIONS Adolescents and girls are at increased risk of trampoline injury, warranting hospitalization. Safety standards may help prevent extremity and musculoskeletal injuries in the pediatric population. Finally, use of trampolines at sporting venues does not appear to be particularly dangerous.
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Affiliation(s)
- Mohammad H Hussein
- From the Department of Surgery, Tulane University, School of Medicine, New Orleans, LA
| | - Ahmad A Toreih
- Department of Orthopedic Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Abdallah S Attia
- From the Department of Surgery, Tulane University, School of Medicine, New Orleans, LA
| | - Majed Alrowaili
- Orthopedic Division, Department of Surgery, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
| | | | - Danielle Tatum
- Our Lady of the Lake Regional Medical Center, Baton Rouge, LA
| | | | - Emad Kandil
- From the Department of Surgery, Tulane University, School of Medicine, New Orleans, LA
| | - Juan Duchesne
- From the Department of Surgery, Tulane University, School of Medicine, New Orleans, LA
| | - Sharven Taghavi
- From the Department of Surgery, Tulane University, School of Medicine, New Orleans, LA
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Bentley M, Amey J, Smith A, Christey G. Paediatric playground and tree-related injuries: Hospital admissions in the Midland region of New Zealand. J Paediatr Child Health 2021; 57:1917-1922. [PMID: 34153135 DOI: 10.1111/jpc.15609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/09/2021] [Accepted: 05/24/2021] [Indexed: 12/01/2022]
Abstract
AIM To examine the incidence and outcomes of paediatric playground and tree-related injuries in the Midland region of New Zealand. METHODS A retrospective review of Midland Trauma Registry hospitalisation data between January 2012 and December 2018 was undertaken. Cases included children aged 0-14 years hospitalised for playground and tree-related injuries. Demographic and event information, injury severity and hospital-related outcomes were examined. RESULTS Playground and tree-related hospitalisations (n = 1941) occurred with an age-standardised rate of 144.3/100 000 (confidence interval (CI) 127.3-161.3) and increased 1.4% (CI 1.3-4.2%) annually. The highest incidence was observed in 5-9-year olds (248.8/100 000) with 0-4 and 10-14-year olds at 86.0 and 89.2/100 000, respectively. Injuries most commonly occurred at home, school or pre-school (77.1%), 93.7% were due to falls and, the upper extremity was the most frequently injured body region (69.9%), particularly due to forearm (55.6%) and upper arm (34.7%) fractures. Tree-related incidents comprised 11.6% of all injuries and explained 57.1% of injuries classified as major severity. Fifty-eight percent of children were hospitalised for 1 day and 97.0% for less than 5 days. Estimated hospital costs were NZ$1.2 million annually with a median of NZ$3898 per incident. Injuries classified as minor severity accounted for 86.5% of the total estimated cost. CONCLUSION Children aged 5-9 years' experience high rates of costly hospitalisation for playground and tree-related injuries. Targeted injury prevention initiatives, particularly in the home and school environments, are imperative to reduce the incidence and burden of playground and tree-related injuries to affected children, their families and hospital resources.
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Affiliation(s)
- Maria Bentley
- Midland Trauma System, Waikato District Health Board, Hamilton, New Zealand
| | - Janet Amey
- Midland Trauma System, Waikato District Health Board, Hamilton, New Zealand
| | - Alastair Smith
- Midland Trauma System, Waikato District Health Board, Hamilton, New Zealand
| | - Grant Christey
- Midland Trauma System, Waikato District Health Board, Hamilton, New Zealand.,Waikato Clinical School, The University of Auckland, Auckland, New Zealand
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Abstract
INTRODUCTION It is well known that trampolines can be a particular source of danger, especially in children. We sought to examine the profile of those patients with trampoline injuries. We hypothesized there would be certain injury patterns predicative of trampoline injuries. METHODS All patients submitted to Pennsylvania Trauma Outcome Study database from 2016 to 2018 were analyzed. Trampoline injury was determined by ICD-10 activity code. Injury patterns in the form of abbreviated injury scale body regions were examined. Patient demographics and clinical variables were compared between those with trampoline injury vs those without. RESULTS There were 107 patients with a trampoline injury. All of these patients were discharged alive and had a blunt mechanism of injury. The most common injury type was injury to the extremities (n=90,[84.1%]) with 54(50.5%) upper extremity injuries and 36(33.6%) lower extremity injuries. Ten (9.35%) patients had injury to the spine and five (4.67%) had head injury. Those with trampoline injuries were significantly younger (13y vs. 48.6y) and more likely to be white or of Hispanic ethnicity. Almost half of the patients injured (49.5%) were under 10 years. Patients with trampoline injuries had significantly lower Injury Severity Scores and significantly higher shock index. DISCUSSION The majority of patients with trampoline injuries had injury to an extremity. These results help better understand the demographic, physiologic, and anatomic patterns surrounding trampoline injuries. Current government standards recommend that no child under age six should use a full-sized trampoline; however, based of this study, we advise that this age be increased to ten.
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Affiliation(s)
- Megan C Sullivan
- 6556Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Madison E Morgan
- 6556Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Eric Bradburn
- Department of Surgery, Division of Trauma and Acute Care Surgery, 209639Penn Medicine Lancaster General Health, Lancaster, PA, USA
| | - Lindsey L Perea
- Department of Surgery, Division of Trauma and Acute Care Surgery, 209639Penn Medicine Lancaster General Health, Lancaster, PA, USA
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Williams BA, Harwood K, Markiewitz N, Malige A, Baldwin KD, Wells L. Seasonal variability and age-related risk in youth trampoline injuries. Pediatr Int 2021; 63:1230-1235. [PMID: 33567121 DOI: 10.1111/ped.14652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 01/25/2021] [Accepted: 02/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this work was to estimate the difference in severity between musculoskeletal trampoline park injuries (TPIs) and home trampoline injuries (HTI) and identify the factors that might mediate or modify that effect. METHODS The National Electronic Injury Surveillance System database was used to identify musculoskeletal home trampoline injuries and TPIs in pediatric patients occurring in the 2009-2017 period. Injury mechanism and body region were inductively coded. The effect of TPI on risk of admission was estimated using a doubly robust logistic regression model for confounding adjustment. Adjustments were made for date, age, gender, injury mechanism, and body region. The comparative importance of injury mechanism and location and the effect modification of patient characteristics was explored using likelihood ratio tests. RESULTS Trampoline park injuries were more likely to result in admission even in the model adjusted for injury mechanism and body region (odds ratio (OR) = 2.12 [1.30, 3.45]). Injuries sustained from falling off the trampoline were associated with significantly fewer hospitalizations (OR = 0.119 [0.029, 0.495]) than injuries from falling while on the trampoline. Patient age significantly modified the effect of setting on risk of admission (P = 0.042). Adolescents demonstrated an increased risk at trampoline parks (15 years old OR = 3.23 [1.38, 7.56]), whereas younger children demonstrated a marginally lower risk (5 years old OR = 0.77 [0.44, 1.35]). CONCLUSIONS Trampoline park musculoskeletal injuries demonstrate an increased risk of admission even after rigorous adjustment for confounding. Injuries to the proximal limbs were associated with a much higher risk of admission than distal injuries. Adolescents face an increased risk of admission after TPI, underscoring the importance of public health interventions that target this age group.
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Affiliation(s)
- Brendan A Williams
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kathleen Harwood
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Nathan Markiewitz
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ajith Malige
- Department of Orthopaedic Surgery, St Luke's University Health Network, Bethlehem, PA, USA
| | - Keith D Baldwin
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lawrence Wells
- Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Abstract
Aims This observational study examines the effect of the COVID-19 pandemic upon the paediatric trauma burden of a district general hospital. We aim to compare the nature and volume of the paediatric trauma during the first 2020 UK lockdown period with the same period in 2019. Methods Prospective data was collected from 23 March 2020 to 14 June 2020 and compared with retrospective data collected from 23 March 2019 to 14 June 2019. Patient demographics, mechanism of injury, nature of the injury, and details of any surgery were tabulated and statistically analyzed using the independent-samples t-test for normally distributed data and the Mann-Whitney-U test for non-parametric data. Additionally, patients were contacted by telephone to further explore the mechanism of injury where required, to gain some qualitative insight into the risk factors for injury. Results The 2020 lockdown resulted in 30% fewer paediatric trauma presentations (441 vs 306), but no significant change in the number of patients requiring surgery (47 vs 51; p = 0.686). Trampolining injuries increased in absolute numbers by 168% (p < 0.001), almost four times more common when considered as percentage of all injuries observed in 2020 vs 2019. There was a decrease in high energy trauma from road traffic accidents and falls from height (21.5% decrease, p < 0.001). Despite a shift towards more conservative treatment options, trampolining injuries continued to require surgery in similar proportions (19.4 vs 20%; p = 0.708). Qualitative investigation revealed that the most common risk factor for trampolining injury was concurrent usage, especially with an older child. Conclusion COVID-19 lockdown has resulted in a decrease in paediatric orthopaedic presentations and high energy trauma. However, due to a marked increase in home trampolining injuries, and their unchanged requirement for surgery, there has been no change in the requirement for surgery during the lockdown period. As home exercise becomes more prevalent, a duty of public health falls upon clinicians to advise parents against trampoline usage. Cite this article: Bone Jt Open 2021;2(2):86–92.
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Affiliation(s)
- Yahya Ibrahim
- Orthopaedic Department, Broomfield Hospital, Mid Essex Hospital NHS Trust, Chelmsford, UK
| | - Sumon Huq
- Orthopaedic Department, Broomfield Hospital, Mid Essex Hospital NHS Trust, Chelmsford, UK
| | | | - Helen Gille
- Orthopaedic Department, Broomfield Hospital, Mid Essex Hospital NHS Trust, Chelmsford, UK
| | - Pranai Buddhdev
- Orthopaedic Department, Broomfield Hospital, Mid Essex Hospital NHS Trust, Chelmsford, UK
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Florido Prados B, Salmanton-Garcia J, Bullmann V, Skouras E. [Characterisation of the impact and features of trampoline park-related injuries]. SPORTVERLETZUNG-SPORTSCHADEN 2020; 34:188-196. [PMID: 32643766 DOI: 10.1055/a-1110-9418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Numerous studies have described indoor trampoline park (ITP)-related injury patterns, but they have shown heterogeneous results. No such study has been performed in Germany to date. The aim of this study was to analyse the specific trampoline-related injury patterns found in our population. METHODS This retrospective study included patients suffering from ITP-related injuries between 1 October 2016 and 30 April 2018. 258 patients were included in the analysis. Patients were categorised depending on different variables including age, sex, site of injury, diagnosis, length of admission and treatment using SPSS. RESULTS In the 19-month study period, 258 patients with ITP-related injuries were recruited. Single ITP-related injuries were diagnosed in 250 (96.9 %) patients. The median age of this group was 22 years (IQR 15-28). 126 (50.4 %) injuries were suffered by men and 124 (49.6 %) by women. 168 (67.2 %) injuries occurred in the lower extremity. Sprains (n = 114, 45.6 %) and fractures without joint dislocation (n = 59, 23.6 %) were the most common diagnoses. Males suffered significantly more often from injuries of the upper extremity (26.2 vs. 9.7 %; p = 0.010), while females most commonly suffered from injuries of the lower extremity (79.8 vs. 54.8 %; p < 0.001). 45 (18 %) patients required hospital admission and twenty-five (10.0 %) patients required surgery. Eight (3.1 %) patients suffered from injuries in more than one anatomic location. CONCLUSIONS ITP-related injuries were more prevalent in adults compared with children. The lower limb was the most affected anatomic location in all ages. The pattern of the injuries was heterogeneous, and their respective treatment represents a major challenge for traumatology surgeons.
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Jääskelä M, Kuivalainen L, Victorzon S, Serlo W, Lempainen L, Sinikumpu JJ. Trampoline-related proximal tibia impaction fractures in children: a population-based approach to epidemiology and radiographic findings between 2006 and 2017. J Child Orthop 2020; 14:125-131. [PMID: 32351625 PMCID: PMC7184643 DOI: 10.1302/1863-2548.14.190177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Proximal tibia impaction fractures are specific injuries, usually caused by trampolining. They may associate with later growth disturbances. There is sparse understanding about their recent epidemiology, in particular the changing incidence. Their typical radiographic findings are not completely known. METHODS All children, aged < 16 years, who had suffered from proximal tibia fracture in Oulu Arc and Oulu between 2006 and 2017 were enrolled (n = 101). Their annual incidence was determined using the official population-at-risk, obtained from the Statistics Finland. The specific characteristics and risk factors of the patients and their fractures were evaluated. Radiographic findings were analyzed, in particular the anterior tilting of the proximal growth plate, due to impaction. RESULTS The annual incidence increased two-fold from 9.5 per 100 000 children (2006 to 2009) to 22.0 per 100 000 (2014 to 2017) (difference: 12.5; 95% confidence interval 5.1 to 20.3 per 100 000; p = 0.0008). The mean annual incidence of trampoline impaction leg fractures was 15.4 per 100 000 children. In 80% of the cases multiple children had been jumping together on the trampoline. Anterior tilting (mean 7.3°, SD 2.5°, 6.1° to 19.1°) ) of the proximal tibial plate was seen in 68.3% of the patients. Satisfactory bone union was found in 92.7% during follow-up. Isolated patients presented delayed bone healing. CONCLUSION The incidence of trampoline leg fractures has increased 130% during the 12 years of the study period. Many of these injuries could have been prevented by avoiding having several jumpers on the trampoline at the same time. Anterior tilting of the growth plate was a common finding and should be recognized in the primary radiographs. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Maija Jääskelä
- Department of Children and Adolescents, Pediatric Surgery and Orthopaedics, Oulu University Hospital and PEDEGO research group, MRC Oulu, Oulu University, Oulu, Finland
| | - Laura Kuivalainen
- Department of Children and Adolescents, Pediatric Surgery and Orthopaedics, Oulu University Hospital and PEDEGO research group, MRC Oulu, Oulu University, Oulu, Finland
| | | | - Willy Serlo
- Department of Children and Adolescents, Pediatric Surgery and Orthopaedics, Oulu University Hospital and PEDEGO research group, MRC Oulu, Oulu University, Oulu, Finland
| | - Lasse Lempainen
- Department of Orthopaedic Surgery, Hospital Mehiläinen NEO, Turku, Finland
| | - Juha-Jaakko Sinikumpu
- Department of Children and Adolescents, Pediatric Surgery and Orthopaedics, Oulu University Hospital and PEDEGO research group, MRC Oulu, Oulu University, Oulu, Finland,Correspondence should be sent to Juha-Jaakko Sinikumpu, Department of Children and Adolescents, Oulu University Hospital, PoB 23, 90029 OYS, Oulu, Finland. E-mail:
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Abstract
Despite previous recommendations from the American Academy of Pediatrics discouraging home use of trampolines, recreational use of trampolines in the home setting continues to be a popular activity among children and adolescents. This policy statement is an update to previous statements, reflecting the current literature on prevalence, patterns, and mechanisms of trampoline-related injuries. Most trampoline injuries occur with multiple simultaneous users on the mat. Cervical spine injuries often occur with falls off the trampoline or with attempts at somersaults or flips. Studies on the efficacy of trampoline safety measures are reviewed, and although there is a paucity of data, current implementation of safety measures have not appeared to mitigate risk substantially. Therefore, the home use of trampolines is strongly discouraged. The role of trampoline as a competitive sport and in structured training settings is reviewed, and recommendations for enhancing safety in these environments are made.
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