Rollerblading injuries in young people

Review of rollerblading injuries

Rollerblading is becoming more popular in the UK and this has led to an increase in injuries. Our aim is to review the characteristics of injuries caused by rollerblading, to compare them in children and adults, to identify risk factors associated with such injuries and to review the role of injury prevention strategies.

Injuries among wheeled shoe users: A comparison with other nonmotorized wheeled activities

BACKGROUND AND OBJECTIVE

Nonmotorized wheeled activities are popular among children. However, these activities can result in significant injury if effective injury prevention measures are not taken. Recently, nonmotorized wheeled shoes have become increasingly popular among children. Preliminary research shows that these activities also result in significant injury. The purpose of the present study was to compare the injury profiles of nonmotorized wheeled activities among Canadian children presenting to the emergency department.

METHODS

A two-year retrospective study was conducted using data from the Canadian Hospitals Injury Reporting and Prevention Program database, specific to the Alberta Children's Hospital, Calgary, Alberta. Data were analyzed using cross tabulations of the type and nature of injury, helmet use, age and sex, with type of nonmotorized wheeled activity.

RESULTS

The most common mechanism of injury for a nonmotorized wheeled activity was bicycling (66.9%), while wheeled shoe use produced the fewest injuries (2.7%). The upper extremity was the most frequently injured body region in all groups, comprising more than 75% of the injuries in wheeled shoe users and approximately 50% of the injuries in participants of other nonmotorized wheeled activities. Forearm fractures were the most common type of injury. Wheeled shoe users had the greatest proportion of forearm fractures. Helmet use was most prevalent in bicyclists (84.6%) and least prevalent in wheeled shoe users (4.7%).

DISCUSSION

Nonmotorized wheeled activities can result in significant morbidity. Results from the present study suggest that wheeled shoe and push scooter activities can result in upper extremity injuries. Protective equipment, particularly wrist guards and helmets, should be used when participating in these activities.

Personal protective equipment use by in-line skaters in Victoria

OBJECTIVE

To describe use of personal protective equipment (PPE) by in-line skaters at four different skate settings (rink, park, trail and street) in Melbourne and rural Victoria, and to compare local PPE with reported international use.

METHOD

Unobtrusive observations of in-line skaters at four types of skate settings (rinks, parks, trails, street) in Melbourne and rural Victoria.

RESULTS

Two-thirds of 490 observed in-line skaters (66.7%) wore none of the recommended PPE (wrist guards, elbow and knee pads and helmets). Only 2.2% wore all four pieces of PPE. Wrist guards were worn by 25.9% of skaters, knee pads by 23.5%, elbow pads by 6.9% and helmets by 5.5%. Younger skaters were least likely to wear any PPE. Trail skaters were more likely to wear PPE than skaters on rinks, parks and streets. Almost one-third of skaters did not have a heel brake on their skates. Use of PPE was influenced by group norms.

CONCLUSION

Personal protective equipment use is low among in-line skaters in Victoria, and varies according to skate location. The use of PPE in Victoria is much lower than that reported overseas.

IMPLICATIONS

Evidence of the effectiveness and the low use of PPE by skaters highlights the need to better promote the use of wrist guards, elbow and knee pads and helmets to skaters of all ages and abilities. There is opportunity for public health professionals to work in partnership with in-line skating bodies, organisers and sponsors of skating events, skate venue owners and managers, skating equipment manufacturers and hirers to promote PPE use.

A Review of Epidemiology of Paediatric Elbow Injuries in Sports

The elbow is a common site of orthopaedic injury in the paediatric population. The number of these injuries continues to rise following increased levels of participation in paediatric recreational and competitive sport. Injuries to the paediatric elbow can be classified as either overuse or acute. Delineating injury patterns to the elbow in children can be challenging, given the cartilaginous composition of the distal humerus and the multiple secondary ossification centres that appear and unite with the epiphysis at defined ages. Pitching in baseball, serving in tennis, spiking in volleyball, passing in American football and launching in javelin-throwing can all produce elbow pathology by forceful valgus stress, with medial stretching, lateral compression and posterior impingement. In children and adolescents, the epiphyseal plate is weaker than the surrounding ligaments, predisposing them to epiphyseal plate injuries. On the other hand, post-pubescent or skeletally mature athletes are more prone to tendinous or ligamentous injury. Injuries may cause significant impact on the athlete, parents and healthcare system. With the exception of baseball, there are few prospective cohort studies on the epidemiological trends of childhood elbow injuries in other sports. This paper aims to describe the epidemiological trends in paediatric elbow injuries related to sports, suggests prevention strategies and discusses the scope for further research. A web-based search of existing articles pertaining to paediatric elbow injuries in sports was performed. The implications of acute and overuse injuries and the possibility of permanent damage should be understood by parents, coaches and the athletes. Proper understanding of the intrinsic and extrinsic risk factors that could lead to elbow injuries is thus required. Measures to prevent elbow injuries should include proper coaching, warm-up, officiation, legislation, medical expertise and protective gear. There are still many opportunities for prospective studies and other research projects among young athletes in various sports. Current studies will serve as a baseline for future research to assess the success of specific interventions in reducing the incidence of elbow injury in the paediatric athlete. Further epidemiological studies in various sports will help expand our knowledge and prevent potential disability and deformity in the paediatric elbow.

[Injury patterns and prophylaxis in inline skating]

Inline skating has become one of the fastest growing sports since its appearance in 1980. The increasing number of inline skaters has also led to a rising incidence of injuries. The most common injury is the distal fracture of the radius, which occurs in 50% of all fractures. There are several reasons for increasing serious injuries in inline skating. The majority of skaters do not wear proper protective equipment (helmet, elbow, knee and wrist protectors), however, many users can not handle their inline skates in dangerous situations. All skaters should take care by buying industrially tested inline skates and appropriate protective equipment; novice skaters should additionally attend special skating schools to learn skating, braking and the the correct falling techniques.

Skatepark injuries and the influence of skatepark design: a one year consecutive case series

Skateboarding and in-line skating are popular activities that attract millions of participants yearly and have spawned the development of skateparks (SPs). This study examined the types and distribution of injuries within a local commercial SP. Subjects were prospectively enrolled in a university Emergency Department (ED) after an injury at a local SP. One hundred subjects were enrolled over 1 year, representing 102 episodes and 106 injuries. Musculoskeletal injuries accounted for 80% of all injuries. Fractures and dislocations were the most frequent injuries (59%); six required operative management. One serious intra-abdominal injury occurred. Head and facial injuries occurred in 17% of subjects; none required operative repair. Admission rate was 9%. Safety equipment use was greater than 91%. Significantly more injuries occurred in the ramp/bars areas compared to the half-pipe and gully areas, suggesting that SP design may significantly influence injury patterns. A substantial number of injuries occurred at the SP, despite controlled conditions and equipment requirements.

Genital injuries in prepubertal girls from inline skating accidents

We report 2 cases where accidents from inline skating resulted in significant genital injury to female children. When genital trauma occurs in children, it frequently raises the concern that sexual abuse might have caused the injury. Historical information provided by the child and others must be compared with the injuries to understand whether an injury may be the result of abuse. We characterize the nature of the genital injuries of our cases as being caused by an accidental "rapid-splits" type mechanism while children were using inline skates. We conclude that the reported accidental mechanism caused the identified injuries. Distinguishing accidental from abusive causes of genital trauma is critical. We report these cases, as there are no reports in the literature regarding this accidental mechanism of injury.

In-line skating injuries

In-line skating has remained a popular recreational activity all over the world. The number of injuries seemingly reached a plateau in the late 1990s. However, there are still more injuries caused by in-line skating than from skateboarding, hockey or lacrosse and rugby. In 1997, the estimated annual cost of medical treatment for these injuries in the US was over $US4 billion. Adolescence still represents the largest group of skaters, both in participation and injury. Although 10- to 14-year-olds account for 60% of injuries, in 1996 the US Consumer Product Safety Commission reported nearly 1500 injuries in individuals 65 years and over. Risk factors for injury include inexperience, aggressive skating and amount of time spent skating. There are also more recent data to suggest that self-reported expert skaters are more likely to sustain an injury. Reluctance to use personal protective equipment (PPE) by in-line skaters remains high. The general consensus is that PPE is effective in reducing the incidence and severity of in-line skating injuries. Therefore, efforts should be made to increase awareness of risk factors for injury in all skaters; to increase use of safety equipment; to provide safe environments for skating; and to legislate skating laws that will protect skaters from injuries.

Effect of elbow flexion on upper extremity impact forces during a fall

OBJECTIVE

The overall objectives are to develop a biomechanical model for a simulated fall with outstretched hand.

DESIGN

Cross-sectional study involving young healthy volunteers in a university research laboratory setting.

BACKGROUND

Little is known about the factors which influence fracture risk during a fall on outstretched hand.

METHODS

A group of 11 male subjects volunteered for this investigation. A set of eight reflective markers was placed bilaterally on selected anatomic landmarks. Subjects were suspended with both elbows extended and wrists dorsiflexed, preparing to impact the ground and force plates from two different fall heights: 3 and 6 cm. Two different postures for the elbows were employed. In the elbow extension experiment, the elbows were extended at all times. In the elbow flexion experiment, the elbows were extended at impact, but then flexed immediately, as though in the initial downward phase of a push-up exercise.

RESULT

Increasing the fall height significantly increased the upper extremity axial forces by 10% and 5%. No significantly different differences were found in the axial forces applied to the wrist, elbow or shoulder between the elbow flexion and elbow extension trials, but the elbow mediolateral shear force was 68% larger (P=0.002) in the extension trials.

CONCLUSIONS

Performing an elbow flexion movement at impact reduces the first peak impact force value and postpones the maximum peak value. Although changing the fall arrest strategy from elbow extension to elbow flexion did not affect the peak impact force on the hand, it did require substantially greater elbow and shoulder muscle strengths.

RELEVANCE

This paper yields insights into how the physical demands of arresting mild falls may relate to upper extremity muscle capacity, joint dislocation and bony fracture.

Scooter injuries: a new pediatric morbidity

OBJECTIVE

To describe types of injuries, mechanisms of injury, and treatment of injuries caused by scooter use in children, and to discuss issues of injury prevention in children who use scooters.

STUDY DESIGN

Data were collected from 14 children seen by a general pediatrician and an orthopedic surgeon over a 3-month period in the summer of 2000. Detailed histories were obtained from patients and their families, and medical records were reviewed.

RESULTS

Eleven of the 14 patients suffered fractures. The injuries in the other 3 patients were a large abrasion, a laceration, and a septic knee. Half (7) of the children were injured within the first day of riding their scooter, and 13 of the 14 injuries occurred within the first month of scooter use. Only 5 patients used protective gear at the time of their injuries, and those patients were injured in unprotected parts of their bodies.

CONCLUSIONS

The popularity of scooters presents a new cause of pediatric injuries and a significant health hazard to children. In our study, most injuries occurred shortly after children began scooter use, and younger children suffered the most severe injuries. Additional studies are needed to determine how scooter-related injuries can be prevented or minimized. scooters, injuries.

Use of protective equipment by in-line skaters: an observational study

OBJECTIVE

To determine the extent of protective equipment use (that is, helmets, wrist guards, elbow pads, knee pads) in a representative sample of in-line skaters.

SETTING

Fifteen municipalities throughout the province of British Columbia.

METHOD

A province-wide observational survey was conducted in the summer of 1999. Skaters were observed at four types of sites (commuter, recreational, neighbourhood, general community) in 15 municipalities to provide a representative sample of in-line skaters.

RESULTS

The observed use of protective equipment by the 877 in-line skaters was relatively low: wrist guards 25%, helmets 13%, elbow pads 14%, and knee pads 10%.

CONCLUSION

Despite the availability of relatively inexpensive protective equipment, few in-line skaters take advantage of the opportunity to protect themselves from injury. Policies and programs that serve to increase the use of protective equipment by in-line skaters are needed to help reduce the frequency of skating related injuries.

Predictors of injury among adult recreational in-line skaters: a multicity study

OBJECTIVES

This study examined risk factors for injury, injury prevalence, safety gear use, and skating habits of adult recreational in-line skaters.

METHODS

Randomly selected in-line skaters in 6 major US cities were interviewed.

RESULTS

Only 6% of skaters consistently wore all 4 recommended types of safety gear. Skaters with greater skating experience were more likely to perform tricks, wear less safety gear, and sustain an injury.

CONCLUSION

More experienced adult recreational in-line skaters are at increased risk for injury. Safety gear use in alarmingly low in adult recreational in-line skaters, especially experienced skaters. Safe skating education programs should consider targeting this newly recognized at-risk skating population.

Survey of injuries and protective gear worn by in-line skaters in public parks

In-line skating, also known as rollerblading, has become popular as a recreational activity as well as a mode of transportation. Increased participation has been accompanied with a marked rise in major and minor injuries. The objective of this study was to survey active in-line skaters and to describe their demographic features, formal training, protective gear used, and a history of incurred injuries. A questionnaire was distributed to randomly selected in-line skaters in a large public park in New York City. Of the 223 skaters who responded, 128 were male and 95 were female. Ages ranged from 12 to 64 (mean, 29) yr. Some kind of injury was reported by 87 (39%) of the participants. The majority of those injuries occurred when the skaters were beginners (46). Skin abrasions and musculoligamentous injuries were the most common. Only 15 (17.2%) sought medical treatment, and of these, 5 were treated for fractures: 3 at the wrist and 1 each at the ankle and knee. The knee was the most commonly injured part of the body (24.7%), followed by the elbow and wrist. Approximately 5% of all injuries involved the head. Many skaters did not wear helmets or knee pads, even though they owned this equipment. There was a strong preference for wearing wrist pads, either alone or with other protective gear. This suggests that skaters have learned that the wrist is particularly vulnerable to serious injury and should be protected.