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Maxson R, Leland CR, Meshram P, Goldfarb SI, Okeke L, McFarland EG. Epidemiology of Pediatric Dog Walking-Related Injuries Among Children Presenting to US Emergency Departments, 2001 to 2020. J Pediatr Orthop 2024; 44:e574-e579. [PMID: 38899976 DOI: 10.1097/bpo.0000000000002702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
BACKGROUND Dog walking is associated with a significant injury burden among adults, but the risk of injury associated with dog walking among children is poorly understood. This study describes the epidemiology of children treated at US emergency departments for injuries related to leash-dependent dog walking. METHODS The National Electronic Injury Surveillance System (NEISS) database was retrospectively analyzed to identify children (5 to 18 years of age) presenting to US emergency departments between 2001 and 2020 with dog walking-related injuries. Primary outcomes included annual estimates of injury incidence, injury characteristics, and risk factors for fracture or traumatic brain injury (TBI). Weighted estimates, odds ratios (ORs), and 95% confidence intervals (CIs) were generated using NEISS sample weights. RESULTS An estimated 35,611 children presented to US emergency departments with injuries related to dog walking. The mean age of patients was 11 years, and most patients were girls (63%). Over half (55%) of injuries were orthopaedic, and patients commonly injured their upper extremity (57%) and were hurt while falling when pulled or tripped by the leash (55%). The most frequent injuries were wrist strain/sprain (5.6%), finger strain/sprain (5.4%), and ankle strain/sprain (5.3%). On multivariable analysis, injured children aged 5 to 11 years were more likely to have sustained a TBI (OR: 3.2, 95% CI: 1.1-9.7) or fracture (OR: 1.6; 95% CI: 1.1-2.3). Boys were more likely than girls to have experienced a fracture (OR: 2.0, 95% CI: 1.3-2.5). CONCLUSIONS Dog walking-related injuries in children are primarily orthopaedic and involve the upper extremity. Younger children and boys are at greater risk for serious dog walking-related injuries. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Ridge Maxson
- Department of Orthopaedic Surgery, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Christopher R Leland
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Prashant Meshram
- Department of Orthopaedic Surgery, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sarah I Goldfarb
- Department of Orthopaedic Surgery, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Laurence Okeke
- Department of Orthopaedic Surgery, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Edward G McFarland
- Department of Orthopaedic Surgery, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, Baltimore, MD
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Siegel MA, Patetta MJ, Deshpande A, Orland MD, Hutchinson MR. Traumatic brain injuries in paediatric patients: individual vs. team sports-related hospitalizations. Res Sports Med 2024; 32:567-579. [PMID: 36647291 DOI: 10.1080/15438627.2023.2166412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/04/2023] [Indexed: 01/18/2023]
Abstract
Paediatric sport participation continues to increase in the United States, with a corresponding increase in sports-related concussions or traumatic brain injuries (TBIs). It is important to recognize which sports are at elevated risk and identify risk factors for hospital admission and length of stay (LOS). Paediatric patients (ages 5-18) from 2008 to 2014 were identified from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS). Eight hundred and ninety-four patients included those who were hospitalized with a TBI resulting from participation in an individual (451 patients) or team (443 patients) sport. We evaluated the differences in LOS and total charges between individual and team sports and found that compared to team sports, TBI patients in individual sports had significantly longer hospital stays compared to team sports (1.75 days versus 1.34 days, p < 0.001) and costlier ($27,333 versus $19,069, p < 0.001) hospital stays. This may be due to reduced awareness and reduced compliance with return-to-play protocols in individual sports. Safety education information at a young age, increased awareness of TBIs, and additional medical support for individual sports as well as team sports may help mitigate these findings.
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Affiliation(s)
- Matthew A Siegel
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael J Patetta
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL, USA
| | - Abhishek Deshpande
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL, USA
| | - Mark D Orland
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL, USA
| | - Mark R Hutchinson
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL, USA
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3
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Baus J, Nguyen E, Harry JR, Yang J. Relevant Biomechanical Variables in Skateboarding: A Literature Review. Crit Rev Biomed Eng 2024; 52:29-39. [PMID: 38780104 DOI: 10.1615/critrevbiomedeng.2024052903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Skateboarding, once regarded primarily as a means of transportation and entertainment for youth, has become a recognized professional sport, gaining global popularity. With its recent inclusion in the Olympics, a growing imperative exists to comprehensively understand biomechanics explaining skateboarding performance. This literature review seeks to consolidate knowledge within this domain, focusing on experimental and modeling studies about skateboard riding and tricks. The criteria for study selection encompassed content relevance and publication year, spanning from the last two decades and extending further back to 1980 following cross-referencing of seminal works. Peer-reviewed journal articles, conference proceedings, and books were considered, with comprehensive searches conducted on electronic databases, including SCOPUS, PubMed, Scielo, and Taylor & Francis. Comprehending the biomechanical facets of skateboarding is essential in promoting its use and ensuring safety among all practitioners. Insights into factors such as body kinetics, kinematics, and muscle activation represent a foundational step toward understanding the nuances of this sport with implications for both clinical and biomechanical research. Modern data collection systems such as inertial measurement units (IMU) and electromyography (EMG) offer unprecedented insights into human performance during skateboarding, such as joint range of motion, coordination, and muscle activation, whether in casual riding or executing complex tricks and maneuvers. Developing robust modeling approaches also holds promise for enhancing skateboarding training and performance. Crucially, these models can serve as the initial framework for understanding injury mechanisms and implementing strategies to improve performance and mitigate injury risks.
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Affiliation(s)
- Juan Baus
- Human-Centric Design Research Lab, Department of Mechanical Engineering, Texas Tech University, Lubbock, TX
| | - Ethan Nguyen
- Human-Centric Design Research Laboratory, Department of Mechanical Engineering, Texas Tech University, Lubbock, TX 79409, USA
| | - John R Harry
- Human Performance & Biomechanics Lab, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
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Nessler JA, Lundquist AL, Jimenez NC, Newcomer SC. Heart Rate Response and Locomotor Activity of Female Skateboarders, BIPOC Skateboarders, and Non-skateboard Users During a Typical Session at a Community Skatepark. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2023; 16:599-612. [PMID: 37621876 PMCID: PMC10446960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Prior research has demonstrated that male adults and youth engaged in skateboarding at community skateparks achieve heart rates that meet or exceed recommendations for exercise by the CDC. However, these studies do not adequately evaluate other non-traditional or ethnically diverse users who may differ in how they utilize the skatepark and in their cardiovascular response. The purpose of this experiment was to measure heart rate response and locomotor movement in three lesser studied groups that frequently utilize community skateparks, and to compare these results with those reported previously in male adult and youth skateboarders. Fifty-six skatepark users were analyzed, including thirty female and BIPOC skateboarders, and twenty-six non-skateboard users. All participants were instrumented with a HR monitor with GPS capability and asked to engage in their preferred activity with no duration specified. Average heart rate and time spent at high and moderate levels of heart rate intensity were not statistically different among the groups studied here, nor were they different from those reported previously for male adult and youth skateboarders. Distances traveled, average, and peak velocities were also not statistically different among the groups studied here, but all were significantly lower than values previously reported for adult male skateboarders. While some differences in distances traveled and velocity were noted, all groups met or exceeded CDC guidelines for cardiovascular fitness. These data suggest that skateparks can help a community achieve health outcomes, particularly among diverse users.
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Affiliation(s)
- Jeff A Nessler
- Department of Kinesiology, California State University-San Marcos, San Marcos, CA, USA
| | - Alivia L Lundquist
- Department of Kinesiology, California State University-San Marcos, San Marcos, CA, USA
| | - Natalie Casas Jimenez
- Department of Kinesiology, California State University-San Marcos, San Marcos, CA, USA
| | - Sean C Newcomer
- Department of Kinesiology, California State University-San Marcos, San Marcos, CA, USA
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Shichman I, Shaked O, Factor S, Ashkenazi I, Elbaz E, Aviv Mordechai R, Khoury A. The association between electric scooter riding position and injury characteristics. JOURNAL OF SAFETY RESEARCH 2023; 84:347-352. [PMID: 36868663 DOI: 10.1016/j.jsr.2022.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/31/2022] [Accepted: 11/18/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND The popularity of electric scooters (e-scooters) and the shared e-scooter services as new means of transportation worldwide led to high numbers of injuries requiring emergency department (ED) visits. Private and rental e-scooters have different sizes and capabilities, offering several possible riding positions. While the rising use of e-scooters and their associated injuries have been reported, little is known about the influence of riding position on injury characteristics. The purpose of this study was to characterize e-scooter riding positions and their related injuries. METHODS E-scooters related ED admissions were retrospectively collected between June 2020 and October 2020, in a level-I trauma center. Demographics, ED presentation data, injury information, e-scooter design, and clinical course were collected and compared according to e-scooter riding position ("foot-behind-foot" vs "side-by-side"). RESULTS During the study period, 158 patients were admitted to the ED with e-scooter related injuries. The majority of riders used the foot-behind-foot position (n = 112, 71.3 %) compared to the side-by-side position (n = 45, 28.7 %). Orthopedic fractures were the most common injuries (n = 78, 49.7 %). "Foot-behind-foot" group had a significantly higher fracture rate compared to "side-by-side" group (54.4 % vs 37.8 % within group, respectively; p = 0.03). CONCLUSIONS Riding position is associated with different injury types, with orthopedic fracture rates significantly higher in the more commonly used "foot-behind-foot" riding position. PRACTICAL APPLICATION These study findings suggest that the common e-scooter narrow-based design is considerably more dangerous, calling for further research to introduce safer e-scooter designs and update recommendations for safer riding positions.
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Affiliation(s)
- Ittai Shichman
- Division of Orthopedics, Tel-Aviv Sourasky Medical Center, Tel-Aviv, affiliated to the Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel
| | - Or Shaked
- Division of Orthopedics, Tel-Aviv Sourasky Medical Center, Tel-Aviv, affiliated to the Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel
| | - Shai Factor
- Division of Orthopedics, Tel-Aviv Sourasky Medical Center, Tel-Aviv, affiliated to the Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel.
| | - Itay Ashkenazi
- Division of Orthopedics, Tel-Aviv Sourasky Medical Center, Tel-Aviv, affiliated to the Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel
| | - Etay Elbaz
- Division of Orthopedics, Tel-Aviv Sourasky Medical Center, Tel-Aviv, affiliated to the Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel
| | - Reut Aviv Mordechai
- Department of Emergency Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv, affiliated to the Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel
| | - Amal Khoury
- Division of Orthopedics, Tel-Aviv Sourasky Medical Center, Tel-Aviv, affiliated to the Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel
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Evans KHC, McAdams RJ, Roberts KJ, McKenzie LB. Sledding-Related Injuries Among Children and Adults Treated in US Emergency Departments From 2008 to 2017. Clin J Sport Med 2021; 31:e460-e466. [PMID: 33323755 DOI: 10.1097/jsm.0000000000000864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/16/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the epidemiology of sledding-related injuries among children and adults treated in US emergency departments (EDs). DESIGN The researchers performed a retrospective analysis using data from the National Electronic Injury Surveillance System (NEISS). SETTING The NEISS collects data on consumer products-related and sports-related injuries treated in US EDs from approximately 100 hospitals that represent a probability sample of >5000 hospitals. PATIENTS Children (≤19 years of age) and adults who were treated for sledding-related injuries in EDs from 2008 to 2017. INDEPENDENT VARIABLES The researchers analyzed characteristics that included sex, body part injured, injury diagnosis, disposition from the ED, injury locale, injury mechanism, and sled type. MAIN OUTCOME MEASURES All cases of sledding-related injuries were identified using NEISS product codes for sleds (1217), toboggans (1273), snow disks (1274), and snow tubes (1299). RESULTS An estimated 220 488 patients [95% confidence interval (CI): 169 839-271 137] were treated in EDs for sledding-related injuries. Overall, the injury rate decreased significantly for both children and adults. Children accounted for 69.7% of the injury cases. Fractures were the most common injury diagnosis for children (23.9%) and adults (27.4%). Compared to adults, children were more likely to sustain a head injury [relative risk (RR): 1.91 (95% CI: 1.73-2.13)] and be diagnosed with a concussion or closed-head injury (CHI) [RR: 1.58 (95% CI: 1.35-1.84)]. Most patients were injured by a collision (63.2%). Snow tube and disk riders were more likely to sustain a concussion or CHI compared to sled and toboggan riders [RR: 1.53 (95% CI: 1.18-1.99)]. Injuries predominantly occurred when patients collided with objects in the environment (47.2%). CONCLUSIONS Although sledding-related injuries decreased over the study period, more research and education to prevent these injuries is needed. The injury patterns and risk of injury type differed by age, with more head injuries sustained by children. Sledding should be performed in obstacle-free areas to reduce the risk of collision and while wearing helmets to mitigate head injuries.
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Affiliation(s)
- Kris H C Evans
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Rebecca J McAdams
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Kristin J Roberts
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Lara B McKenzie
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, Ohio; and
- Division of Epidemiology, The Ohio State University, College of Public Health, Columbus, Ohio
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7
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Rod JE, Oviedo-Trespalacios O, King M. A retrospective registry analysis of the transport-related health burden of wheeled recreational devices in Queensland, Australia. Aust N Z J Public Health 2021; 46:208-215. [PMID: 34648211 DOI: 10.1111/1753-6405.13162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/01/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Evaluate injury patterns from wheeled recreational devices (WRD) in the public space and explore risk factors for hospital admission. METHOD A cross-sectional analysis of WRD injury prevalence and risk factors for hospital admissions was conducted using data from the Queensland Injury Surveillance Unit (QISU) database for 2007 to 2017. Descriptive statistics and a log-binomial regression model were used to calculate adjusted relative risk for hospital admission. RESULTS Most WRD injury in the public space was related to stand-alone WRD injury events such as falls, with few reported WRD users being hit by vehicles from 2007 to 2017. Stand-alone WRD injury events had a higher independent risk of hospital admissions when injured in the head/neck/face (RR 2.08, 95%CI 1.6 to 2.8, p<0.001), and when the injury was a fracture (RR 2.57, 95%CI 2.1 to 3.3, p<0.001) or a brain injury (RR 3.19, 95%CI 2.5 to 4.1, p<0.001). CONCLUSION Head, brain and facial injuries and fractures are leading preventable factors for hospital admissions due to WRD injury. These types of injuries generate a preventable burden to the health system. Implications for public health: The results support the need to consider legislation regarding mandatory helmet use for non-motorised WRD when used on public roads and footpaths, while further research is conducted. This strategy could reduce the long-term health outcomes associated with head, face and brain injury in young commuters.
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Affiliation(s)
- J E Rod
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
| | - Oscar Oviedo-Trespalacios
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
| | - Mark King
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
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Electric Scooter-Related Injuries: A New Epidemic in Orthopedics. J Clin Med 2021; 10:jcm10153283. [PMID: 34362067 PMCID: PMC8348701 DOI: 10.3390/jcm10153283] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/18/2022] Open
Abstract
Background: The use of electric scooters has increased considerably as they are an accessible means of transportation. The number of injuries from falls and collisions has risen significantly. Therefore, the aim of the study was to describe demographics injury patterns of electric scooter accidents produced over one year. Methods: A prospective observational study of electric scooter- related injuries presented in the emergency room from May 2019 until May 2020. The inclusion criteria was based on the direct cause of injury produced while an electric scooter was in use. Demographic data, the use of a helmet or the lack thereof, accident mechanism, injury time, type of injury produced, and the treatment applied were collected. Results: Over the study period, 397 patients were identified with a total of 422 injuries. The mean age was 30.8 years, with 12.6% of patients being minors. The patients mainly presented in evening hours and in summertime at the emergency department. Of the total injuries seen, 46.9% were fractures. Some 25% of the total cases required surgery. Only 19% of the riders wore a helmet at the time of the accident. Most of the fractures were to the upper limbs (62.6%). There was a greater incidence of radius fractures. Conclusion: Injuries incurred while using electric scooters are an emerging phenomenon, despite existing regulations. In this study, most injuries occurred in young men and were due to falls from the vehicle. Nearly half of those injuries were fractures to the upper limbs. Surprisingly, 50% of the fractures required surgery.
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Furr HN, Nessler JA, Newcomer SC. Characterization of Heart Rate Responses, Duration, and Distances Traveled in Youth Participating in Recreational Skateboarding at Community Skateparks. J Strength Cond Res 2021; 35:542-548. [PMID: 29939901 DOI: 10.1519/jsc.0000000000002686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Furr, HN, Nessler, JA, and Newcomer, SC. Characterization of heart rate responses, duration, and distances traveled in youth participating in recreational skateboarding at community skateparks. J Strength Cond Res 35(2): 542-548, 2021-Recreational skateboarding continues to gain popularity in youth within the United States and abroad. Surprisingly, there is a paucity of research regarding the cardiovascular responses of youth participating in recreational skateboarding. Therefore, the purpose of this study was to test the hypothesis that skateboarding would elicit heart rates and durations consistent with the American College of Sports Medicine (ACSM) and Center for Disease Control and Prevention (CDC) recommendations for cardiovascular fitness in youth. Seventy-one recreational skateboarders (boys: 63 and girls: 8) between the ages of 6 and 17 years participated in this study. Data were acquired at 9 skateparks in the local community. After parental consent, subjects completed a questionnaire and were instrumented with a heart rate monitor (Polar V800 GPS Sports Watch), which recorded heart rate, duration, and distance traveled. Subjects were instructed to engage in typical skateboarding activities, with the duration and intensity of activity determined by the individual. Subjects were 10.6 ± 2.9 years old and had participated in skateboarding for 3.1 ± 2.4 years. On average, subjects skateboarded 55.5 ± 28.4 minutes, at an average heart rate of 140.4 ± 16.1 b·min-1, and traveled an average distance of 2.65 ± 1.87 km. Results from this study suggest that youth participating in recreational skateboarding at community skateparks attain exercise intensities and durations that are comparable with the ACSM's and CDC's exercise recommendations for cardiovascular fitness in youth. These findings may hold implications for city planners considering the impact of community skateparks on physical activity in youth and overall public health.
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Affiliation(s)
- Heather N Furr
- Department of Kinesiology, California State University San Marcos, San Marcos, California
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10
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Orthopedic Injuries Associated with Hoverboard Use in Children: A Multi-center Analysis. HSS J 2020; 16:221-225. [PMID: 33380950 PMCID: PMC7749912 DOI: 10.1007/s11420-019-09682-2] [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: 11/07/2018] [Accepted: 03/28/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Since its release in 2015, the hoverboard has been associated with injuries in children and adolescents. However, its public health implications have yet to be explored in the orthopedic literature across multiple centers. PURPOSE/QUESTIONS We sought to assess the nature of orthopedic injuries and the use of clinical resources related to the hoverboard at four high-volume, regional pediatric hospitals. METHODS Departmental databases of emergency department (ED) consultations and urgent orthopedic clinic (UC) visits were queried for hoverboard injuries. A retrospective medical record review was performed for patients presenting over a 3-month period at four institutions. Data on demographics, injuries, clinical course, and resource use were analyzed. The frequency of hoverboard-related consultations was compared to those for monkey bar-related injuries at the primary study institution. RESULTS Eighty-nine patients with orthopedic hoverboard injuries presented to the ED and/or UC in the study period. Hoverboard injuries represented 2.2% of orthopedic ED consultations at the primary institution, compared to 1.5% for monkey bar injuries. Sixty-nine out of 89 (77.5%) total injuries involved the upper extremity, including 47 (52.8%) distal radius fractures, the most common hoverboard-related diagnosis. All but one injury (97.8%) underwent radiography, and eight (9%) required surgery. No patients reported wearing protective gear at the time of their injury. CONCLUSIONS Hoverboards were associated with a variety of pediatric orthopedic injuries and required the use of significant resources in the ED, UC, and operating room. These data may represent a starting point for further prospective multi-center studies and public health efforts toward prevention of hoverboard injuries.
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McIntosh AS, Patton DA, McIntosh AG. Managing head injury risks in competitive skateboarding: what do we know? Br J Sports Med 2020; 55:836-842. [PMID: 33032991 DOI: 10.1136/bjsports-2020-102013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The broad objective of this paper is to inform policy, practice and research regarding the management of head injury risks in competitive skateboarding. The main motivation for the current study was the question of mandating helmet use in competitive skateboarding. The specific aims are to present current knowledge on (A) head injury risks in skateboarding, (B) preliminary biomechanical data on falls and head injury risks in a selection of competitive skateboarding events similar to those planned for the Summer Olympics, (C) standards for skateboard-styled helmets and (D) impact performance of helmets commonly used in skateboarding. METHODS A narrative review of the published literature on head injuries in skateboarding was conducted. Videos of skateboarding competitions from Vans Park Professional League, Street League Skateboarding and Dew Tour were reviewed to describe crashes and falls. Standards databases including the International Organization for Standardization (ISO), British Standards Institution (BSI), Snell, United States Consumer Product Safety Commission (CPSC) and American Society for Testing and Materials (ASTM) were searched for skateboarding-styled helmet standards. A sample of helmets considered suitable for skateboarding was tested in standard impact tests. RESULTS The majority of previous literature focused on the paediatric population in a recreational setting with little data from competitive skateboarding. Head injuries comprised up to 75% of all injuries and helmet use was less than 35%. Video analysis identified high rates of falls and crashes during competitive skateboarding, but also a capacity for the athletes to control falls and limit head impacts. Less than 5% of competitive skateboarders wore helmets. In addition to dedicated national skateboard helmet standards, there are several national standards for skateboard-styled helmets. All helmets, with the exception of one uncertified helmet, had similar impact attenuation performance; that is, at 0.8 m drop height, 114-148 g; at 1.5 m, 173-220 g; and at 2.0 m, 219-259 g. Impact performance in the second impact was degraded in all helmets tested. CONCLUSION Helmets styled for skateboarding are available 'off the shelf' that will offer protection to the head against skull fractures and intracranial injuries in competitive skateboarding. There is an urgent need to commence a programme of research and development to understanding and control head injury risks.
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Affiliation(s)
- Andrew Stuart McIntosh
- School of Engineering and ACRISP, Edith Cowan University, Joondalup, WA, Australia .,McIntosh Consultancy and Research, Sydney, NSW, Australia
| | - Declan Alexander Patton
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Sport Injury Prevention Research Centre, University of Calgary, Calgary, AB, Canada
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12
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Keays G, Friedman D, Gagnon I. Injuries in the time of COVID-19. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2020; 40:336-341. [PMID: 32924925 DOI: 10.24095/hpcdp.40.11/12.02] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Research has shown that during the 2003 SARS pandemic, emergency department (ED) visits among the pediatric population decreased. We set out to investigate if this was also true for injury-related ED visits during the COVID-19 pandemic. METHODS Using data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), we looked at 28 years of injury-related ED visits at the Montreal Children's Hospital, a provincially designated Pediatric Trauma Centre. We compared data from a two-month period during the COVID-19 lockdown (16 March to 15 May) to the same period in previous years (1993-2019) to determine whether the 2020 decrease in ED visit numbers was unprecedented (i.e. a similar decrease had never occurred) for different age groups, nature of injuries, mechanisms and severity. RESULTS The 2020 decrease was unprecedented across all age groups between 1993 and 2019. When compared with the 2015 to 2019 average, the decrease was smallest in children aged 2 to 5 years (a 35% decrease), and greatest in the group aged 12 to 17 years (83%). Motor vehicle collisions and sports-related injuries practically vanished during the COVID-19 lockdown. Surprisingly, more children aged 6 to 17 years presented with less urgent injuries during the COVID-19 lockdown than in previous years. CONCLUSION As was the case with SARS in 2003, COVID-19 acted as a deterrent for pediatric ED visits. The lockdown in particular had a profound impact on injury-related visits. The de-confinement period will be monitored to determine the impact in both the short and the long term.
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Affiliation(s)
- Glenn Keays
- Trauma, Montreal Children's Hospital Trauma Centre, McGill University Health Centre, Montréal, Quebec, Canada.,Canadian Hospitals Injury Reporting and Prevention Program, Montreal Children's Hospital, McGill University Health Centre, Montréal, Quebec, Canada
| | - Debbie Friedman
- Trauma, Montreal Children's Hospital Trauma Centre, McGill University Health Centre, Montréal, Quebec, Canada.,Canadian Hospitals Injury Reporting and Prevention Program, Montreal Children's Hospital, McGill University Health Centre, Montréal, Quebec, Canada.,Department of Pediatrics and Pediatric Surgery, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada.,The WELL Office, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
| | - Isabelle Gagnon
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada.,Division of Pediatric Emergency Medicine, McGill University Health Centre, Montreal Children's Hospital, Montréal, Quebec, Canada
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13
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Rodríguez-Rivadulla A, Saavedra-García MÁ, Arriaza-Loureda R. Skateboarding Injuries in Spain: A Web-Based Survey Approach. Orthop J Sports Med 2020; 8:2325967119884907. [PMID: 32232064 PMCID: PMC7082873 DOI: 10.1177/2325967119884907] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: The inclusion of skateboarding in the Tokyo 2020 Olympic Games reinforces this activity as a sport. As the number of skateboarders around the world and the difficulty of skateboarding maneuvers continue to increase, the number of skateboarding injuries may also rise. Thus, there is a need for more comprehensive investigations into the practice habits and injuries of skateboarders. Purpose: To describe the sports habits and skateboarding injuries of a sample of skateboarders in Spain. Study Design: Descriptive epidemiology study. Methods: A web-based survey was shared among skateboarders in Spain. The survey collected data related to sports habits, skateboarding practice habits, and injury history. Comparisons between subgroups of sex, age, and experience were also conducted. Results: The survey was completed by 197 participants (89.3% male) with a mean age of 24.4 ± 7.1 years and a mean experience of 9.7 ± 7.2 years. Most respondents (87.8%) reported not participating in any type of skateboarding-specific physical training program. Only 27.4% took part in skateboarding competitions, with a larger number of respondents younger than 18 years participating in competitive events. The mean number of sessions per week was 3.3 ± 1.7, and the mean length of sessions was 3.3 ± 1.5 hours. The majority of participants (87.8%) reported having suffered injuries (n = 323) as a result of skateboarding, mainly affecting the lower limbs (69.7%). The most common injury type was a ligament sprain (39.6%), especially of the ankle (39.3%). This injury was also reported as the most likely to recur (70.1%). A large number of injuries (54.2%) were considered severe (ie, >21 days to recover). Most injuries occurred while skateboarding gaps or stairs, including any type of a jump that involved a difference in height between the take-off and landing surfaces (25.7%). Female participants accounted for a larger number of ligament sprains than expected, and experienced skateboarders were more likely to suffer more severe injuries and head/trunk injuries. Conclusion: Respondents to this survey were mainly young male adults who practiced skateboarding recreationally. Respondents of different sexes, ages, and experiences demonstrated different habits and injury patterns. The greater number of severe injuries highlights the need for injury surveillance in skateboarding to inform better prevention and rehabilitation practices.
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Affiliation(s)
- Adrián Rodríguez-Rivadulla
- Department of Physical Education and Sports, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Miguel Ángel Saavedra-García
- Department of Physical Education and Sports, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Rafael Arriaza-Loureda
- Department of Physical Education and Sports, Faculty of Sport Sciences and Physical Education, University of A Coruña, A Coruña, Spain
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14
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Talathi NS, Ganley TJ, Shea KG, Schwend RM, Baldwin KD. Pediatric Lawnmower Injuries and Strategies for Prevention: A Systematic Review. JBJS Rev 2019; 6:e9. [PMID: 30589748 DOI: 10.2106/jbjs.rvw.18.00037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Lawnmower injuries remain a preventable cause of serious morbidity and even mortality in children. We aimed to characterize lawnmower injuries in children and to describe reported mechanisms through a review of the literature to better understand these injuries and their prevention. METHODS The Embase and MEDLINE databases were queried for studies pertaining to pediatric lawnmower injuries, along with manual searching of references of included studies and Google Scholar searches. Reviews and case reports were excluded. Studies relating to lawnmower injuries were broadly included to ensure capture of the relevant studies. Studies with both adult and pediatric data were included if pediatric data were granular and available for separate analysis. RESULTS Thirteen studies met inclusion criteria: 8 single-center series and 5 national database studies. Age of injury was bimodal with peak frequencies at ages 3 and 16 years. National studies estimated a mean of 11.2 injuries per 100,000 children, with 5% to 8% of patients hospitalized. Analysis of both single-center series and national database studies revealed 3 major mechanisms of injury: blade injuries, projectile injuries, and burn injuries. Blade injuries resulted in higher morbidity, with a greater need for operative management, amputation, and longer length of hospitalization. Similarly, rider mowers posed a greater injury risk than push mowers. CONCLUSIONS This systematic review of lawnmower injuries in children identified patterns and mechanisms of injuries across the literature that may serve to educate parents, policy-makers, and health-care providers as well as provide data to develop and improve prevention strategies.
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Affiliation(s)
- Nakul S Talathi
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | | | | | - Keith D Baldwin
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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15
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Tuckel PS, Milczarski W, Silverman DG. Changing Incidence and Nature of Injuries Caused by Falls From Skateboards in the United States. Clin Pediatr (Phila) 2019; 58:417-427. [PMID: 30596266 DOI: 10.1177/0009922818821872] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since 2000, the number of emergency department visits and hospital admissions for children who have sustained a fall from a skateboard has undergone a noticeable decline. One possible explanation for this decline is that children today lead a more sedentary lifestyle and are not as engaged in outdoor physical activities as were children in previous generations. The profile of patients injured in skateboarding-related accidents has also changed since 2000. The percent minority, percent residents of large metropolitan areas, and percent who incur an injury on a street or highway have all increased during this time period. Data based on observations of riders in skateboard parks indicate that the overwhelming majority do not wear protective gear such as helmets, elbow/knee pads, or wrist guards, and that a sizable segment of riders compound their risk of injury by using headphones or earbuds when performing maneuvers.
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Affiliation(s)
- Peter S Tuckel
- 1 Hunter College-City University of New York, New York, NY, USA
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16
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Investigation of the Lower Extremity Fractures in Children Who Applied to the Emergency Department of University Hospital. JOURNAL OF CONTEMPORARY MEDICINE 2019. [DOI: 10.16899/gopctd.503015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Caine DJ, Provance AJ. Pediatric and adolescent injury in adventure and extreme sports. Res Sports Med 2019; 26:5-19. [PMID: 30431358 DOI: 10.1080/15438627.2018.1434041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Dennis J Caine
- a Department of Kinesiology and Public Health Education , University of North Dakota , Grand Forks , ND , USA
| | - Aaron J Provance
- b Department of Orthopedics , University of Colorado School of Medicine , Aurora , CO , USA
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18
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Glenney B, Mull S. Skateboarding and the Ecology of Urban Space. JOURNAL OF SPORT AND SOCIAL ISSUES 2018; 42:437-453. [PMID: 30510332 PMCID: PMC6269152 DOI: 10.1177/0193723518800525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Skateboarding poses a unique case study for considering the place of sport in human activity. The bulk of skateboarding scholarship argues that skateboarding is largely a subversion of rule governance, a view difficult to square with common and popular rule-governed skateboarding competitions, now including the Olympics. We attempt to resolve this tension by arguing for a kind of pluralism: skateboarding's engagement in rule-governed competition is distinctly subversive, yielding the claim that skateboarding is both sport and subversion. This pluralism is examined in an "ecological" framework of emergent activities defined by push-pull interactive relationships between skateboarders and their environment that change the meaning of their spaces-whether domestic, urban, or competitive-to spaces that are both wild and spontaneous. We conclude with reflections on how skateboarding provides understanding of sport in the space of ecological meaning.
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19
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Abstract
Skateboarding has become an international action sport attractive to young people. For this reason, skateboarding has been promoted by some researchers as important for encouraging young people to become more physically active. However, skateboarding is also considered to be inherently dangerous by the medical and broader community and as a result skateboarding is banned in many places. This paper reviews scientific literature on the features, outcomes and risk factors related to skateboarding injuries. Findings suggest that while skateboarding injuries can be severe, skateboarding is not as dangerous as it might appear if appropriate risk management steps are taken. Skateboarding should be encouraged as a worthy physical activity and local communities should consider providing specialised, supervised spaces for young people to practice this sport.
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Affiliation(s)
- Francesco Feletti
- a Department of Diagnostic Imaging , Ausl della Romagna, Santa Maria delle Croci Hospital , Ravenna , Italy.,b Department of Electronics , Information and Bioengineering, Politecnico di Milano University , Milano , Italy
| | - Eric Brymer
- c Institute of Sport Physical Activity and Leisure , Leeds Beckett University , Leeds , UK
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20
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Epidemiological investigation of traumatic upper extremity fractures in children who applied to emergency department. JOURNAL OF CONTEMPORARY MEDICINE 2018. [DOI: 10.16899/gopctd.454562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Weber CD, Horst K, Nguyen AR, Lefering R, Pape HC, Hildebrand F. Evaluation of severe and fatal injuries in extreme and contact sports: an international multicenter analysis. Arch Orthop Trauma Surg 2018; 138:963-970. [PMID: 29675749 DOI: 10.1007/s00402-018-2935-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Indexed: 01/21/2023]
Abstract
PURPOSE The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention. METHODS We compared demographic data, severity and patterns of injuries; and the pre- and in-hospital management from an international population-based prospective trauma database (TraumaRegister DGU®). The registry was screened for sport-related injuries, and only patients with major injuries [Injury Severity Score (ISS) ≥ 9 points] related to extreme or contact sports activities were included (January 1, 2002, to December 31, 2012). Parameters were compared for different types of sports activities: (1) Airborne sports, (2) Climbing, (3) Skateboarding/Skating, (4) Contact sports. The following countries participated: Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, New York). RESULTS A total of 278 athletes were identified within the study period and classified into four groups: Airborne sports (n = 105) were associated with the highest injury severity (ISS 22.4 ± 14.6), followed by climbing (n = 35, ISS 16.5 ± 12), skating (n = 67, ISS 15.2 ± 10.3) and contact sports (n = 71, ISS 10.4 ± 9.2). Especially high falls resulted in a significant rate of spinal injuries in airborne activities (68.6%, p < 0.001) and in climbing accidents (45.7%). Skating was associated with the highest rate of loss of consciousness (LOC) at scene (27.1%), the highest pre-hospital intubation rate (33.3%), and also the highest in-hospital mortality (15.2%, p < 0.001), related to major head injuries. CONCLUSIONS Extreme and contact sports related major injuries predominantly affect young male athletes. Especially skaters are at risk for debilitating and lethal head injuries. Individuals recognizing sport-specific hazards might modify their risk behavior. LEVEL OF EVIDENCE Descriptive Epidemiologic Study, Level II.
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Affiliation(s)
- Christian D Weber
- Department of Orthopaedics and Trauma, RWTH Aachen University, Pauwels street 30, 52074, Aachen, Germany. .,Olympic Center Rhineland, Aachen, Germany.
| | - Klemens Horst
- Department of Orthopaedics and Trauma, RWTH Aachen University, Pauwels street 30, 52074, Aachen, Germany
| | - Anthony R Nguyen
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia
| | - Rolf Lefering
- Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU), Cologne, Germany
| | | | - Frank Hildebrand
- Department of Orthopaedics and Trauma, RWTH Aachen University, Pauwels street 30, 52074, Aachen, Germany
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22
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Pediatric Orthopedic Hoverboard Injuries: A Prospectively Enrolled Cohort. J Pediatr 2017; 190:271-274. [PMID: 29144253 DOI: 10.1016/j.jpeds.2017.07.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/08/2017] [Accepted: 07/20/2017] [Indexed: 11/21/2022]
Abstract
Hoverboards pose a significant risk of musculoskeletal injury to pediatric riders. A prospectively enrolled cohort yielded 9 pediatric patients injured while riding hoverboards in 2016. Eight of the injuries involved the upper extremity, and one involved the lower extremity. No riders wore any safety equipment and injury patterns modeled those seen in skateboard riders.
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