Trampoline injuries

A Review of 13,470 Head and Neck Injuries from Trampoline Jumping

Study Design

The authors designed a 20-year cross-sectional study using the National Electronic Injury Surveillance System (NEISS) database.

Objective

The purpose of the study is to determine the risk factors for hospital admission among individuals who suffer head and neck injuries secondary to trampoline use.

Methods

The primary predictor variables were a set of heterogenous variables that were categorized into the forementioned study variable groups (patient characteristics and injury characteristics). The primary outcome variable was hospital admission. Multivariate logistic regression was used to determine independent risk factors for hospital admission.

Results

The final sample consisted of 13,474 reports of trampoline injuries to the head and neck. Relative to females, males (OR 1.66, P < .05) were at an increased risk for hospital admissions. Fractures (OR 35.23, P < .05) increased the risk for hospital admissions relative to dental injuries. Concerning anatomical region of injury, neck injuries (OR 30.53, P < .05) were at an increased risk for hospital admissions.

Conclusions

Injuries to the neck from trampoline jumping significantly increased the risk for admission. The severity of neck injuries from trampoline jumping is well established in the literature. Additionally, male sex and fractures were each risk factors for hospital admission. Given the rising prevalence of trampoline-related head and neck injuries over the past 2 decades, it is crucial for individuals to take the necessary precautions when jumping on a trampoline.

Trampoline centre injuries in children and adolescents: a systematic review and meta-analysis

CONTEXT

No evidence-based review has compared injury risks sustained on trampolines at home and in trampoline centres.

OBJECTIVE

To present pooled results for injury type, site and treatment from studies reporting injuries that occurred on trampolines at home and in trampoline centres.

DATA SOURCES

MEDLINE, Scopus, Google Scholar and Embase databases were searched to 31 December 2021.

STUDY SELECTION

Inclusion criteria: (1) assessment of trampoline injuries (home and trampoline centres); (2) children and adolescents; (3) the point estimate was reported as an odds ratio (OR); and (4) an internal comparison was used.

DATA EXTRACTION

Data were reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A random-effects model was used to estimate effect.

RESULTS

There were 1 386 843 injuries (n=11 studies). There was an increased likelihood of musculoskeletal and/or orthopaedic injuries (OR 2.45, 95% CI 1.66 to 3.61, p<0.001), lower extremity injury (OR 2.81, 95% CI 1.99 to 3.97, p<0.001), sprains (OR 1.64, 95% CI 1.36 to 1.97, p<0.001) and a need for surgery (OR 1.89, 95% CI 1.37 to 2.60, p<0.001) at trampoline centres compared with home trampolines. Conversely, upper extremity injury (OR 0.49, 95% CI 0.25 to 0.95, p=0.03), concussion (OR 0.48, 95% CI 0.35 to 0.65, p<0.001) and lacerations (OR 0.46, 95% CI 0.35 to 0.59, p<0.001) were less likely to occur at trampoline centres than at home.

CONCLUSIONS

Children using trampoline centres are more likely to suffer severe trauma and require surgical intervention than children using home trampolines. Development and implementation of preventative strategies, public awareness, and mandatory safety standards are urgently required for trampoline centres.

Trampolining Accidents in an Adult Emergency Department: Analysis of Trampolining Evolution Regarding Severity and Occurrence of Injuries

PURPOSE

Only a few studies have been conducted on trampoline-associated injuries in adults, especially in Switzerland. The aim of the present study was to describe the characteristics of trampoline-related injuries in patients older than 16 years of age and track their development over time by comparing two different time periods.

METHODS AND MATERIALS

Data were gathered from the emergency department (ED) of Bern University Hospital. A retrospective design was chosen to allow analysis of changes in trampolining accidents between 2003-2020.

RESULTS

A total of 144 patients were enrolled. The number of ED presentations due to trampoline-related injury rose significantly over time. The most common injuries were sprains to the extremities (age group 31-62: 58.4% and age group 16-30: 50.8%), followed by fractures (age group 31-62: 33.3% and age group 16-30: 32.5%). Lower extremities appeared to be the most frequently injured body region (age group 31-62: 20.8% and age group 16-30: 10.0%), although the differences were not statistically significant, p = 0.363. BMI was significantly higher for older than for younger patients (p = 0.004).

CONCLUSION

Over the last two decades, trampoline-related injuries have become more common in patients older than 16 years of age. These are most common in the lower extremities. While most of the patients in the present study only suffered minor injuries, the occasional severe injury might result in long-term disability. As trampoline-related injuries in adults are becoming more common, prevention strategies in public education and safety instructions must be optimised.

Olympic Sports Science-Bibliometric Analysis of All Summer and Winter Olympic Sports Research

Introduction: The body of scientific literature on sports and exercise continues to expand. The summer and winter Olympic games will be held over a 7-month period in 2021-2022. Objectives: We took this rare opportunity to quantify and analyze the main bibliometric parameters (i.e., the number of articles and citations) across all Olympic sports to weigh and compare their importance and to assess the structure of the "sport sciences" field. The present review aims to perform a bibliometric analysis of Olympic sports research. We quantified the following topics: (1) the most investigated sports; (2) the main journals in which the studies are published; (3) the main factors explaining sport-specific scientific attractiveness; (4) the influence of being in the Olympic programme, economic weight, and local influences on research output; and (5) which research topic is the most investigated across sports. Methods: We searched 116 sport/exercise journals on PubMed for the 40 summer and 10 winter Olympic sports. A total of 34,038 articles were filtered for a final selection of 25,003 articles (23,334 articles on summer sports and 1,669 on winter sports) and a total of 599,820 citations. Results and Discussion: Nine sports [football (soccer), cycling, athletics, swimming, distance & marathon running, basketball, baseball, tennis, and rowing] were involved in 69% of the articles and 75% of the citations. Football was the most cited sport, with 19.7 and 26.3% of the total number of articles and citations, respectively. All sports yielded some scientific output, but 11 sports (biathlon, mountain biking, archery, diving, trampoline, skateboarding, skeleton, modern pentathlon, luge, bobsleigh, and curling) accumulated a total of fewer than 50 publications. While ice hockey is the most prominently represented winter sport in the scientific literature, winter sports overall have produced minor scientific output. Further analyses show a large scientific literature on team sports, particularly American professional sports (i.e., baseball, basketball, and ice hockey) and the importance of inclusion in the Olympic programme to increasing scientific interest in "recent" sports (i.e., triathlon and rugby sevens). We also found local/cultural influence on the occurrence of a sport in a particular "sport sciences" journal. Finally, the relative distribution of six main research topics (i.e., physiology, performance, training and testing, injuries and medicine, biomechanics, and psychology) was large across sports and reflected the specific performance factors of each sport.

A Measurement of 'Walking-the-Wall' Dynamics: An Observational Study Using Accelerometry and Sensors to Quantify Risk Associated with Vertical Wall Impact Attenuation in Trampoline Parks

This study illustrates the application of a tri-axial accelerometer and gyroscope sensor device on a trampolinist performing the walking-the-wall manoeuvre on a high-performance trampoline to determine the performer dynamic conditions. This research found that rigid vertical walls would allow the trampolinist to obtain greater control and retain spatial awareness at greater levels than what is achievable on non-rigid vertical walls. With a non-rigid padded wall, the reaction force from the wall can be considered a variable force that is not constrained, and would not always provide the feedback that the trampolinist needs to maintain the balance with each climb up the wall and fall from height. This research postulates that unattenuated vertical walls are safer than attenuated vertical walls for walking-the-wall manoeuvres within trampoline park facilities. This is because non-rigid walls would provide higher g-force reaction feedback from the wall, which would reduce the trampolinist's control and stability. This was verified by measuring g-force on a horizontal rigid surface versus a non-rigid surface, where the g-force feedback was 27% higher for the non-rigid surface. Control and stability are both critical while performing the complex walking-the-wall manoeuvre. The trampolinist experienced a very high peak g-force, with a maximum g-force of approximately 11.5 g at the bottom of the jump cycle. It was concluded that applying impact attenuation padding to vertical walls used for walking-the-wall and similar activities would increase the likelihood of injury; therefore, padding of these vertical surfaces is not recommended.

Trampoline-related fractures of the proximal tibia in children

Background

Trampoline-related fractures of the proximal tibial metaphysis are common in children and have been linked to subsequent valgus deformity of the tibia. The purpose of this study was to investigate the characteristics of trampoline-related proximal tibial fractures in young children.

Methods

We evaluated 40 patients with proximal tibial fracture after trampolining between 2013 and 2019. The median duration of follow-up was 18 months. Standing long leg radiographs were obtained at the last follow-up to evaluate angular deformity and limb length inequality in the patients. The measurements recorded include the lower limb length, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), mechanical axis deviation (MAD), and anatomical tibio-femoral angle (aTFA). The anterior tilt angle (ATA) was measured using a lateral radiograph of the tibia.

Results

The median age at injury was 40.0 months. Using trampoline with a heavier person was the most common mechanism of injury. aTFA and MAD were found to be increased towards the valgus at the last follow-up in our patient; however, the increase was not statistically significant (p = 0.692 and p = 0.973, respectively). The anterior tilt angle was increased in the injured leg at the last follow-up. But the change was not statistically significant (p = 0.09).

Conclusions

Using trampoline with a heavier person carries the risk of trampoline-related proximal tibial fracture in young children. We did not find a significant change in limb alignment at a minimum of one year of follow-up.

Trampoline-related proximal tibia impaction fractures in children: a population-based approach to epidemiology and radiographic findings between 2006 and 2017

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.

Demographic changes in US trampoline-related injuries from 1998 to 2017: cause for alarm

BACKGROUND

Recreational sports facilities with trampolines have become increasingly popular, and trampoline-related injuries incurred have been increasing. The goal of this study was to determine impact of recreational sports facilities on trampoline-associated injuries.

METHODS

An epidemiological study was performed using data from the National Electronic Injury Surveillance System (NEISS). All patients in the NEISS database coded for trampoline injury were included. Statistical analyses were performed comparing home trampoline injuries (HTIs) and recreational sports facilities-related trampoline injuries (RSIs) for standard demographic variables using appropriated weighted statistical methods.

RESULTS

There were an estimated 1 376 659 emergency department (ED) visits for trampoline related injuries from 1998 to 2017; 125 811 were RSIs and 1 227 881 were HTIs. Between 2004 and 2017, the number of RSIs increased rapidly, while HTIs decreased. RSIs more often presented to large hospitals and HTIs to smaller ones. Strain/sprains were more associated with RSIs, whereas HTIs sustained more internal organ injuries. Lower extremity fractures occurred more frequently in RSIs and upper extremity fractures in HTIs. There was a greater percentage of RSIs in 15-34 years old age group (28.2% vs 13.6%). There were no differences by gender and race between HTIs and RSIs.

CONCLUSIONS

The rapid expansion in recreational sports facilities with trampolines coincided with increasing RSIs. RSIs differed from HTIs regarding changes over time, hospital size, diagnosis and injury location. Recreational sports facilities with trampolines pose a public health hazard.

Pediatric Injuries in Kids Cafés and Risk Factors for Significant Injuries: a 6-Year Cross-Sectional Study Using a Multicenter Injury Registry in Korea

BACKGROUND

A kids café is a popular indoor playground in Korea that combines a playground for young children and a café for their caregivers. There have been no national reports about kids café-related injuries in Korea. This study investigated kids café-related injuries in Korea registered in a multicenter injury surveillance database and analyzed the risk factors for significant kids café-related injuries.

METHODS

A multicenter cross-sectional study was performed using the Emergency Department-based Injury In-depth Surveillance registry in Korea between 2011 and 2016. Significant injury was defined as an injury requiring hospitalization or surgery. A multivariable logistic regression model was used to obtain the adjusted odds ratios (aORs) for factors associated with significant kids café-related injuries.

RESULTS

Among 1,537,617 injured patients, we extracted 891 patients who were injured in kids cafés. Of these, 46 (5.2%) were admitted, and 39 (4.4%) underwent surgery. The most common injured anatomical site, injury type, and mechanism were lower extremity (28.2%), superficial injury (27.2%), and slip (27.1%), respectively. Among injury-inducing factors, significant injuries were most commonly caused by a trampoline (28.1%), and rock climbing equipment was the only risk factor in a kids café that led to significant injury after adjusting for age, sex, injury mechanism, and injured anatomical sites (aOR, 14.94; 95% confidence interval, 1.51-147.72).

CONCLUSION

The rock climbing equipment in a kids café can cause serious injury to children. Establishing safety regulations for rock climbing equipment in kids cafés may have the greatest impact in reducing significant injuries requiring hospitalization or surgery.

A retrospective review of trampoline-related injuries presenting to a paediatric emergency department in Singapore

INTRODUCTION

Trampolining is a popular activity. However, to our knowledge, no studies on paediatric trampoline-related injuries (TRIs) have been conducted in Asia. We aimed to provide an Asian perspective on paediatric TRIs and evaluate current safety measures.

METHODS

Patients aged under 16 years who presented to the emergency department at KK Women's and Children's Hospital, Singapore, from March 2012 to June 2016 with a TRI were identified from the National Trauma Registry. Data was collated retrospectively focusing on age, location of the trampoline, mechanism and location of injury, treatment, disposition, and follow-up treatment.

RESULTS

137 children were seen for a TRI during this period. There was even representation across age groups (< 6 years, 6-11 years and 11-16 years). 60.6% of these injuries occurred in a public trampoline park, and a smaller proportion involved home and school trampolines. 61.3% of injuries occurred on the trampoline and 25.5% involved a fall off it, while the remaining were incurred by hitting the trampoline frame. The most common injury was soft tissue injury, followed by fractures and dislocations, of which 16.7% required surgical intervention. Most patients were discharged to an outpatient clinic. 14.6% of all patients required admission and 9.5% eventually required surgical intervention. There were three stable head injuries and no cervical spine injuries or deaths.

CONCLUSION

The existence of trampoline parks has contributed to a rise in TRIs. We recommend measures such as general education, changes in the setup around the trampoline, increasing the age limit for trampolining, adult supervision and discouraging double bouncing.

COMPARISON OF BUNGEE-AIDED AND FREE-BOUNCING ACCELERATIONS ON TRAMPOLINE

Trampolines remain the single best apparatus for the training of aerial acrobatics skills.  Trampoline use has led to catastrophic injuries from poor landings.  Passive injury prevention countermeasures such as specialized matting have been largely ineffective.  Active injury countermeasures such as hand spotting, “throw-in” mats, and overhead spotting rigs provide the most effective methods.  The recent addition of several bungee cords between the ropes and the gymnast’s spotting harness has resulted in altered teaching and coaching of trampoline-related acrobatics.  Bungee cords have eliminated the need for a coach/spotter to manage the ropes during skill learning.  The purpose of this study was to assess the influence of the addition of bungee cords with a traditional rope-based overhead spotting rig.  There is a paucity of any research involving trampoline injury countermeasures.  Ten experienced trampoline acrobatic athletes (5 males, 5 females) from the U.S. Ski and Snowboard Association Aerials National Team performed 10 bounces as high as they could control.  A triaxial accelerometer (200 Hz) characterized 10 bungee cord aided bounces and 10 free-bounces on a trampoline from each athlete.  Bed contact times, peak accelerations, and average accelerations were obtained.  The results supported our hypotheses that the bungee-aided bounces achieved only 40% (average) to 70% (peak) of the free-bouncing accelerations (all ρ < 0.001 and all ƞ2partial >0.092).  The bed contact time was approximately 65% longer during the bungee-aided bounces (ρ < 0.001).  Bungee cords may reduce the harshness of landings on trampoline.

Trampoline Park Injuries and Their Burden on Local Orthopaedic and Emergency Services

OBJECTIVE

To investigate the incidence of trampoline park injuries (TPIs) at a local recreational facility and to quantify the burden on emergency and orthopaedic services at our institute.

METHODS

All patients that presented to the Emergency Department (ED) from the trampoline park via ambulance from July 2014 to November 2015 were included in the study. Patients' medical records were reviewed for clinical details including date, location and type of injury, treatment received, length of stay and outpatient follow-up. A cost analysis was performed to estimate the financial impact of each injury.

RESULTS

A total of 71 patients were included in the study, with a mean age of 20 (7-48). Soft tissue sprains (n=29, 41%) and fractures (n=25, 35%) were the most common injuries, with the majority occurring in the lower limb. Two patients sustained open tibial fractures necessitating transfer to level 1 trauma centres. Fourteen patients (20%) underwent surgery, predominantly requiring open reduction and internal fixation. Overall, 18 patients (25%) required admission to hospital with mean length of stay of 2 days. The cost for pre-hospital, emergency and in-patient care amounted to over £80,000.

CONCLUSION

TPIs pose a significant financial cost for local orthopaedic and emergency services. Contrary to studies evaluating home trampoline injuries, the majority of fractures at trampoline parks occurred in the lower limbs. Improved injury prevention strategies are required to help reduce morbidity and lower the financial implications for local NHS trusts.

The ups and downs of trampolines: Injuries associated with backyard trampolines and trampoline parks

Objective

To compare characteristics associated with backyard trampoline injuries (BTI) and trampoline park injuries (TPI) using records from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP).

Methods

eCHIRPP records for trampoline injuries (2012 to 2016) were extracted using variable codes and narratives, and injuries were examined among individuals 17 years and younger. Descriptive estimates for BTI and TPI, as well as age and sex adjusted odds ratios (OR) for the mechanism, source, body part and type of injury associated with TPIs relative to BTIs, are presented.

Results

Trampoline injuries are increasing in Canada (P<0.01). Patients with TPIs were older than those with BTIs. Relative to BTIs, TPIs were more associated with impact as the mechanism (OR 2.6, 95% CI: 2.2 to 3.1), trampoline beds as the source (OR 1.7, 95% CI: 1.4 to 2.1), lower extremity as the body part (OR 3.7, 95% CI: 3.0 to 4.4) and sprains as the type of injury (OR 2.0, 95% CI: 1.6 to 2.4). In contrast, another jumper (OR 0.5, 95% CI: 0.4 to 0.6) or fall (OR 0.4, 95% CI: 0.4 to 0.6) as the mechanism, surface (OR 0.7, 95% CI: 0.5 to 0.9) or another jumper (OR 0.5, 95% CI: 0.4 to 0.7) as the source, face or neck (OR 0.6, 95% CI: 0.4 to 0.7) as the body part, and lacerations (OR 0.6, 95% CI: 0.3 to 0.9) or soft tissue injury (OR 0.7, 95% CI: 0.6 to 0.9) as the type of injury were more associated with BTIs relative to TPIs.

Conclusion

Trampoline parks result in injuries different than those from backyard trampolines. This examination into the distinct injury characteristics can help to inform future prevention measures.

Heart rate, energy expenditure, and affective responses from children participating in trampoline park sessions compared with traditional extra-curricular sports clubs

BACKGROUND

Lack of physical activity (PA) is becoming an issue in younger populations. Trampoline parks are newly popular environments for PA yet research on their use is scarce. Thus the present study compared heart rate, energy expenditure, and affective responses in children participating in trampoline park sessions compared with extracurricular sports clubs.

METHODS

Children (aged 6-11 years; N.=16 females, N.=10 males) participated in 3 trampoline park sessions and 3 extracurricular sports club sessions lasting ~45 minutes over 3 weeks. Heart rate, energy expenditure, and affective responses through the circumplex model, were measured.

RESULTS

Both conditions elicited moderate-vigorous PA. Average heart rate (mean difference [95%CIs]=27.6 fc [23.5 to 31.8]), peak heart rate (mean difference [95%CIs]=24.2 fc [20.8 to 27.6]) and energy expenditure (mean difference [95%CIs]=3.2 kcals.min-1 [2.7 to 3.6]) were all significantly higher for the trampoline sessions. Affective responses for both conditions elicited feelings of "excitement."

CONCLUSIONS

Both extracurricular sports clubs and trampoline park activities provide moderate-vigorous PA, though the latter may result in higher heart rate and energy expenditure responses. Both however produce similar positive affective responses. As such, both could be valuable options for PA opportunities for children.

Pediatric Trampoline-Related Injuries in a Nationwide Registry in South Korea, 2011 to 2016

PURPOSE

Trampoline-related injuries are steadily increasing. To our knowledge, there have been very few studies on trampoline injuries in Asia. The purpose of this study is to report the characteristics of pediatric trampoline injuries in Korea.

MATERIALS AND METHODS

We conducted a nationwide retrospective cohort study. Data were collected from prospective nationwide databases (Emergency Department-based Injury In-depth Surveillance databases of the Korea Centers for Disease Control and Prevention) for patients who visited emergency departments (EDs) after injuries during 2011-2016.

RESULTS

Of 263712 patients between 0 and 17 years of age, 2799 patients with trampoline injuries visited EDs. The median age of the patients was 5 years (interquartile range, 3-8 years), and 63% of the patients were under 6 years old. Of the patients, 1526 (54.2%) were male. Seventy-six percent of injuries occurred at trampoline parks. Trampoline injuries and trampoline park injuries have increased steadily, while ages at injury have gradually decreased year by year (p<0.001). Injury locations included the lower extremity (47%), head and face (24%), and upper extremity (24%). A fracture was sustained by 886 (31.7%) patients. The distal humerus and proximal tibia were the most common fracture sites (34% and 23%, respectively). Fractures occurred more commonly in trampoline parks than in homes (33.7% vs. 21.1%, p<0.001).

CONCLUSION

In Korea, pediatric trampoline injuries and trampoline park injuries have tended to increase, while ages at injury have tended to decrease. Policies to prevent trampoline injuries are needed.

Trampolines: What's the Harm?

Trampolines hold the promise of fun and enjoyment for many children, but they are associated with a significant number of orthopedic and other injuries. Injuries vary from minor to severe, and the most common are extremity injuries. Although most injuries are associated with residential (ie, backyard) trampolines, a growing number of injuries now occur in trampoline parks. Adult supervision has not been effective for prevention. Emerging data on trampoline park-related injuries indicate that caution should be exercised in these settings as well. [Pediatr Ann. 2018;47(10):e385-e387.].

Parental Knowledge of Trampoline Safety in Children

OBJECTIVE

Recreational trampoline use is increasing in popularity, with a resulting increase in significant trampoline-related injuries in children. Parents are the best advocates for the safety of their children during recreational trampoline use. Our primary objective was to determine the proportion of parents who were aware of 5 key recommendations for safer recreational trampoline use in children.

METHODS

This was a cross-sectional survey of parents whose children presented to a tertiary care pediatric emergency department with an extremity injury. Survey questions were derived and validated using expert opinion, available literature, and pre- and pilot testing of questions on the target audience.

RESULTS

Of the 1415 enrolled parents, 654 (46.2%) had regular access to a trampoline and 125 (8.8%) of their children had a history of trampoline injury. A total of 116 (8.2%; 95% confidence interval, 6.8-9.6) parents were aware of all 5 key safety recommendations for home trampoline use. Specifically, the proportion of parents who reported knowledge of the requirement for active supervision, regularly inspected safety equipment, avoiding stunts, multiple jumpers, and use by children 6 years of age and older was 89.0%, 77.2%, 44.3%, 41.6%, and 18.3%, respectively.

CONCLUSIONS

Trampoline safety knowledge of the 5 key recommendations among parents was low, specifically with respect to recommended age, number of jumpers, and stunts. Because it is unlikely that use of recreational trampolines will decrease, a harm reduction approach that includes a public knowledge translation strategy of recommendations for safer home use of trampolines is necessary.

Evaluation of primary caregivers' perceptions on home trampoline use

Trampolines are widely used by children, but trampoline injuries can be severe and may require hospital care or even surgery. This pilot study examined the effectiveness of an educational intervention on caregivers' perceptions of trampoline use and safety for their children.

Primary caregivers were recruited from the orthopedic clinic at the Children's Hospital at our institution in 2015. Caregivers were asked to complete a survey at two time points, initially in clinic and one week post educational intervention. The educational intervention was a pamphlet outlining trampoline safety data. Data analysis occurred in 2016.

From the 100 primary caregivers recruited, 39 caregivers owned a trampoline, and 10 had presented to the emergency department with their child for an injury related to trampoline use. After educational intervention, caregivers had higher rating of perceived danger associated with trampolines (6/10 vs. 8/10, p < 0.001). Additionally, a greater number of caregivers were more knowledgeable on the safe age of trampoline use (56% vs. 91%, p < 0.001) and safe number of jumpers (45% vs. 86%, p < 0.001). Finally, there was a 29% increase in the proportion of caregivers who at least agreed that trampolines are dangerous (pre: 44% vs. post: 73%, p < 0.001), however 50% of caregivers would still allow their child to use a trampoline.

Overall, the results of this study show that a simple educational intervention can help to increase knowledge around safe trampoline practices and increase awareness of injury. Further, this study can act as initial evidence for future studies to implement this type of intervention long-term.

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Rating of perceived danger of trampolines increased after educational intervention.

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Educational intervention improved knowledge of safe trampoline practices.

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Caregivers are receptive to recommendations against trampoline use from physicians.

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Two-thirds agreed that trampolines are dangerous after educational intervention.

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After education half of caregivers would still allow their child to use trampolines.

Trampoline injuries in the world and in Turkey

Trampoline continues to be an activity that individuals in every age, but particularly children, enjoy to do for nearly a hundred years. However, it has some unpleasant effects due to the risk of injury. Safety rules, therefore, need to be followed during trampoline activities. Contemporarily, it is not recommended for small children and purposes other that sportive activities in Western countries. In this review, we discuss the trampoline-related injuries to increase the awareness in the society and to shape the regulations related with the trampoline use in Turkey.

Competitive trampolining influences trabecular bone structure, bone size, and bone strength

BACKGROUND

Trampolining is a form of gymnastics that has increased in popularity over the last decade and due to its concurrence with the formative years of bone development, it may have an important impact on bone health. However, bone density, microarchitecture, and bone strength of competitive trampolinists have not been explored. Therefore, the purpose of this cross-sectional study was to investigate the relationship between trampolining participation and (1) bone density, area, and microarchitecture; and (2) estimated bone strength and the role of muscle and impact loading in young female adults.

METHODS

We recruited 29 female participants aged 16-29 years for this study (n = 14 trampolinists; n = 15 controls). Skeletal parameters were assessed using dual X-ray absorptiometry, high-resolution peripheral quantitative computed tomography (HR-pQCT), and finite element analysis (FEA). Muscle strength was measured using dynamometers.

RESULTS

Trampolinists had higher bone density at the hip and spine, greater trabecular density and thicker trabeculae at the tibia, as well as larger bones at both the tibia and radius than controls (p < 0.05). Trampolinists also had higher muscle strength than controls at the lower body with no difference between groups in the upper body. Estimates of bone strength using FEA were greater for trampolinists than controls at both the radius and tibia.

CONCLUSION

This is the first study to investigate bone density, area, and microarchitecture in female trampolinists using HR-pQCT. Trampolinists had greater bone density, area, microarchitecture, and estimated bone strength than controls.

Trampoline Park and Home Trampoline Injuries

BACKGROUND AND OBJECTIVE

Trampoline parks, indoor recreational facilities with wall-to-wall trampolines, are increasing in number and popularity. The objective was to identify trends in emergency department visits for trampoline park injuries (TPIs) and compare TPI characteristics with home trampoline injuries (HTIs).

METHODS

Data on trampoline injuries from the National Electronic Injury Surveillance System from 2010 to 2014 were analyzed. Sample weights were applied to estimate yearly national injury trends; unweighted cases were used for comparison of injury patterns.

RESULTS

Estimated US emergency department visits for TPI increased significantly, from 581 in 2010 to 6932 in 2014 (P = .045), whereas HTIs did not increase (P = .13). Patients with TPI (n = 330) were older than patients with HTI (n = 7933) (mean 13.3 vs 9.5 years, respectively, P < .001) and predominantly male. Sprains and fractures were the most common injuries at trampoline parks and homes. Compared with HTIs, TPIs were less likely to involve head injury (odds ratio [OR] 0.64; 95% confidence interval [CI], 0.46-0.89), more likely to involve lower extremity injury (OR 2.39; 95% CI, 1.91-2.98), more likely to be a dislocation (OR 2.12; 95% CI, 1.10-4.09), and more likely to warrant admission (OR 1.76; 95% CI, 1.19-2.61). TPIs necessitating hospital admission included open fractures and spinal cord injuries. TPI mechanisms included falls, contact with other jumpers, and flips.

CONCLUSIONS

TPI patterns differed significantly from HTIs. TPIs are an emerging concern; additional investigation and strategies are needed to prevent injury at trampoline parks.

Trampoline related injuries in adults

INTRODUCTION

Trampoline-related injuries in adults are uncommon. Participation in trampolining is increasing following its admission as a sport in the Olympics and the opening of local recreational trampoline centres. The aim of this study was to assess the number and outcomes of adult trampoline-related orthopaedic injuries presenting to four trauma hospitals in Victoria.

METHODS

A cohort study was performed for the period 2007-2013. Adult patients registered by the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) who had sustained a trampolining related injury were included in this study. Descriptive analyses were used to describe the patient population, the injuries sustained and their in-hospital and 6-month outcomes.

RESULTS

There was an increase in trampolining injuries from 2007 (n=3) to 2012 (n=14) and 2013 (n=18). Overall, fifty patients with a median age of 25 (range 16-66) were identified. Thirty-five patients (70%) had lower limb injuries, 20 patients (40%) had spinal injuries and one patient had an upper limb injury. Thirty-nine patients (78%) required surgery. Fractures of the tibia (n=13), ankle fractures (n=12) and cervical spine injuries (n=7) were the most common injuries; all of which required surgery. Complications included death, spinal cord injuries, compartment syndrome and open fractures. At 6 months post injury, more than half (52%) of the patients had not achieved a good recovery, 32% had some form of persistent disability, 14% did not get back to work and overall physical health for the cohort was well below population norms for the SF-12.

CONCLUSION

Adult trampoline-related injuries have increased in the last few years in this cohort identified through VOTOR. Lower limb and spinal injuries are most prevalent. Public awareness and education are important to reduce the risk for people participating in this activity.

Iliacus haematoma causing femoral nerve palsy: an unusual trampolining injury

We report the case of a 15-year-old boy who presented to accident and emergency following a trampolining injury. Initially, the patient was discharged, diagnosed with a soft tissue injury, but he re-presented 48 h later with worsening low back pain and neurological symptoms in the left leg. Subsequent MRI revealed a left iliacus haematoma causing a femoral nerve palsy. The patient was managed conservatively and by 6 months post injury all symptoms had resolved. This is the first reported case of an iliacus haematoma causing a femoral nerve palsy, after a trampolining injury. We believe this case highlights to our fellow clinicians the importance of a detailed history when assessing patients with trampolining injuries to evaluate the true force of injury. It also acts as a reference for clinicians in managing similar cases in future.

Fractures from trampolines: results from a national database, 2002 to 2011

BACKGROUND

No study specifically analyzes trampoline fracture patterns across a large population. The purpose of this study was to determine such patterns.

METHODS

We queried the National Electronic Injury Surveillance System database for trampoline injuries between 2002 and 2011, and the patients were analyzed by age, sex, race, anatomic location of the injury, geographical location of the injury, and disposition from the emergency department (ED). Statistical analyses were performed with SUDAAN 10 software. Estimated expenses were determined using 2010 data.

RESULTS

There were an estimated 1,002,735 ED visits for trampoline-related injuries; 288,876 (29.0%) sustained fractures. The average age for those with fractures was 9.5 years; 92.7% were aged 16 years or younger; 51.7% were male, 95.1% occurred at home, and 9.9% were admitted. The fractures were located in the upper extremity (59.9%), lower extremity (35.7%), and axial skeleton (spine, skull/face, rib/sternum) (4.4%-spine 1.0%, skull/face 2.9%, rib/sternum 0.5%). Those in the axial skeleton were older (16.5 y) than the upper extremity (8.7 y) or lower extremity (10.0 y) (P<0.0001) and more frequently male (67.9%). Lower extremity fractures were more frequently female (54.0%) (P<0.0001). The forearm (37%) and elbow (19%) were most common in the upper extremity; elbow fractures were most frequently admitted (20.0%). The tibia/fibula (39.5%) and ankle (31.5%) were most common in the lower extremity; femur fractures were most frequently admitted (57.9%). Cervical (36.4%) and lumbar (24.7%) were most common locations in the spine; cervical fractures were the most frequently admitted (75.6%). The total ED expense for all trampoline injuries over this 10-year period was $1.002 billion and $408 million for fractures.

CONCLUSIONS

Trampoline fractures most frequently involve the upper extremity followed by the lower extremity, >90% occur in children. The financial burden to society is large. Further efforts for prevention are needed.

The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies

BACKGROUND

Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist.

OBJECTIVE

Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity.

METHODS

We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields.

RESULTS

One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain.

CONCLUSIONS

Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains.

Increased incidence of distal humeral fractures and surgical treatment in 0- to 18-year-old patients treated in Finland from 1987 to 2010

BACKGROUND

Studies of pediatric and adolescent fractures in general report a significant increase in the incidence of upper-extremity fractures as well as in their surgical treatment. The aim of this study was to determine the trends of the incidence and treatment of distal humeral fractures in hospitalized 0- to 18-year-old patients in Finland.

METHOD

The study included the entire pediatric and adolescent (<19 years) population in Finland during the 24-year period from 1 January 1987 to 31 December 2010. Data on hospitalized patients were obtained from the nationwide National Hospital Discharge Registry where information is collected from all hospital categories (private, public, and other). Surgical treatment was categorized into three groups; (1) reposition with casting; (2) reposition or reduction and osteosynthesis; (3) reposition or reduction and external-fixation and other fixation methods. Patients were classified into three groups according to age: 0-6 years, 7-13 years, and 14-18 years. Annual incidences were calculated using the annual mid-year population census obtained from the Official Statistics of Finland.

RESULTS

During the 24-year study period, there were a total of 12,590 hospitalizations with a main or secondary diagnosis of distal humeral fracture. In children aged 0-12 years the overall incidence of hospitalization increased 30 % during the 24-year study period, from 4.5 per 10,000 person-years in 1987 to 5.8 per 10,000 person-years in 2010. There were a total of 5,548 operations. During the study period, surgical treatment by repositioning or reduction with osteosynthesis due to a distal humeral fracture increased by fivefold in patients aged <6 years and by twofold in patients aged 7-12 years of age. The incidences of fracture and treatment in children older than 13 years did not change.

CONCLUSION

The incidence of distal humeral fractures and the incidence of repositioning with osteosynthesis increased remarkably in prepubertal children during the 24-year study period in Finland.

[Safety measures for trampolines cannot prevent severe injuries]

BACKGROUND

The number of injuries caused by accidents while springing on a trampoline has increased significantly. This study therefore focused on the incidence, morbidity and circumstances of the accidents in pediatric patients.

METHODS

The children admitted to this hospital from 2002 to 2010 were re-examined and the children injured during trampolining were asked to fill out a questionnaire focusing on the mechanism of the injury and the circumstances.

RESULTS

A total of 268 accidents were included in the study and 28% of the injuries were severe (e.g. fracture, luxation and rupture). If there were special safety measures (e.g. safety net, floor mats, surrounding water 63%) 28.4% of the injuries were severe and without safety measures 28.6% were severe. Safety measures did not influence the incidence of severe trauma (p=1). If a trampoline was equipped with a safety net (53%) 31% of the injuries were severe and without a safety net 25% were severe (p=0.473).

CONCLUSION

Pediatric accidents on a trampoline result in severe injuries in 28% of cases. There is no difference in the severity of the injury regarding trampolines with or without special safety measures. Safety nets do not reduce the risk of severe injury.

Trampoline related injuries in children: risk factors and radiographic findings

BACKGROUND

Backyard trampolines are immensely popular among children, but are associated with an increase of trampoline-related injuries. The aim of this study was to evaluate radiographs of children with trampoline related injuries and to determine the risk factors.

METHODS

Between 2003 and 2009, 286 children under the age of 16 with backyard trampoline injuries were included in the study. The number of injuries increased from 13 patients in 2003 to 86 in 2009. The median age of the 286 patients was 7 years (range: 1-15 years). Totally 140 (49%) patients were males, and 146 (51%) females. Medical records and all available diagnostic imaging were reviewed. A questionnaire was sent to the parents to evaluate the circumstances of each injury, the type of trampoline, the protection equipment and the experience of the children using the trampoline. The study was approved by the Institutional Ethics Committee of the University Hospital of Bern.

RESULTS

The questionnaires and radiographs of the 104 patients were available for evaluation. A fracture was sustained in 51 of the 104 patients. More than 75% of all patients sustaining injuries and in 90% of patients with fractures were jumping on the trampoline with other children at the time of the accident. The most common fractures were supracondylar humeral fractures (29%) and forearm fractures (25%). Fractures of the proximal tibia occurred especially in younger children between 2-5 years of age.

CONCLUSIONS

Children younger than 5 years old are at risk for specific proximal tibia fractures ("Trampoline Fracture"). A child jumping simultaneously with other children has a higher risk of suffering from a fracture.

Fractures in children: epidemiology and activity-specific fracture rates

BACKGROUND

Approximately one-third of pediatric fractures occur during sport or recreational activity. In this paper, we investigate the incidence and causes of pediatric fractures in our region and quantify the fracture rate per exposure time for the most common sport and recreational activities.

METHODS

We prospectively evaluated all children younger than sixteen years who presented to our institution with a new fracture within a twelve-month period. Exposure time to the most common childhood activities was measured by means of interviewing random parents from the study population. The main outcome measures were the annual fracture incidence in the population and fracture rates per 10,000 hours of exposure to various sports and recreational activities.

RESULTS

A total of 1403 fractures were included. The overall annual incidence was 180.1 fractures per 10,000 children younger than sixteen years. The distal part of the radius was most often fractured (436 fractures, 31.1%). Snowboarding was associated with the highest activity-specific fracture rate, estimated to be 1.9 (95% confidence interval [CI], 1.16 to 2.60) fractures per 10,000 hours of exposure. In comparison, the fracture rate per 10,000 hours of exposure was 0.79 (CI, 0.42 to 1.09) for handball, 0.44 (CI, 0.35 to 0.52) for soccer, and 0.35 (CI, 0.23 to 0.47) for trampolining.

CONCLUSIONS

The distal part of the radius is the most common fracture site in childhood. Fracture rates differ between various physical activities. The fracture rate for snowboarding was four times higher compared with that for other common childhood sport and recreational activities in our region.

Specific injuries induced by the practice of trampoline, tumbling and acrobatic gymnastics

PURPOSE

The recreational and competitive practice of acrobatic sports, that is, trampoline, tumbling and acrobatic gymnastics (ACRO), is growing rapidly around the world. Many studies described the injuries affecting young artistic gymnasts, but only few concerned acrobatic sports.

METHODS

During a 5-year period, 357 traumatic events were collected in young acrobats practicing trampoline, tumbling or ACRO. Accident characteristics, level of expertise and training, injury location (upper limb, spine and lower limb), type of tissue injured (bone, cartilage, muscle, ligament and tendon) and provoking factors (intrinsic/behavioural and extrinsic) were investigated.

RESULTS

Acrobats of national and international levels were mostly injured. Injuries occurring in acrobatic sports concerned predominantly the lower limbs and concerned in this body part mainly damages to ligaments. Forearm and knee injuries were preferentially related to trampoline. Ankle injuries were preferentially related to tumbling. Wrist injuries were preferentially related to ACRO. Upper limb bone damage and upper limb tendon damage were preferentially related to trampoline and ACRO, respectively. Intrinsic/behavioural factors were the main injury determinant in the three acrobatic sports.

CONCLUSIONS

The main injuries in acrobatic sports (i.e. lower limbs) are similar to those observed in artistic gymnastics. Specific injuries may result from falls and incomplete and/or erroneous figure's landing and may also depend to the type of the landing surface.

LEVEL OF EVIDENCE

II.

Trampoline safety in childhood and adolescence

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.

Survey of injury sources for a trampoline with equipment hazards designed out

AIM

In Australia, trampolines contribute approximately one-quarter of all childhood play-equipment injuries. The purpose of this study was to gather and evaluate injury data from a nontraditional, 'soft-edged', consumer trampoline in which the equipment injury sources have been designed out.

METHODS

A survey was undertaken in Queensland and New South Wales. The manufacturer of the nontraditional trampoline provided the University of Technology, Sydney, with their Australian customer database. Injury data were gathered in a pilot study by phone interview, then in a full study through an email survey. Results from 3817 respondents were compared with earlier Australian and US data from traditional trampolines gathered from emergency departments.

RESULTS

  A significantly lower proportion of the injuries caused by falling off or striking the equipment was found for this new design when compared with traditional trampolines both in Australia and in the USA. The age of children being injured on trampolines in Australia was found to be markedly lower than in North America.

CONCLUSIONS

This research indicates that with appropriate design the more severe injuries on traditional trampolines can be significantly reduced.

Injury survey of a non-traditional 'soft-edged' trampoline designed to lower equipment hazards

In Australia trampolines contribute one quarter of all childhood play equipment injuries. The objective of this study was to gather and evaluate injury data from a non-traditional, 'soft-edged', consumer trampoline, where the design aimed to minimise injuries from the equipment and from falling off. The manufacturer of the non-traditional trampoline provided the University of Technology Sydney with their Australian customer database. The study involved surveys in Queensland and New South Wales, between May 2007 and March 2010. Initially injury data was gathered by a phone interview pilot study, then in the full study, through an email survey. The 3817 respondents were the carers of child users of the 'soft-edge' trampolines. Responses were compared with Australian and US emergency department data. In both countries the proportion of injuries caused by the equipment and falling off was compared with the proportion caused by the jumpers to themselves or each other. The comparisons showed a significantly lower proportion resulted from falling-off or hitting the equipment for this design when compared to traditional trampolines, both in Australia and the US. This research concludes that equipment-induced and falling-off injuries, the more severe injuries on traditional trampolines, can be significantly reduced with appropriate trampoline design.

Trampoline trauma in children: is it preventable?

OBJECTIVES

Trampoline injuries represent a preventable cause of injury in children. This study identified the characteristics of children injured while using trampolines who presented to a pediatric trauma center in Sydney, Australia.

METHODS

The Pediatric Trauma Database at our institution was reviewed to identify children with trampoline-related injuries between January 1999 and June 2008. Data collected included age, sex, Injury Severity Score, anatomical region injured, type of injury, mechanism of injury, site of injury and surface fallen onto, level of supervision, treatment, and hospital length of stay.

RESULTS

Over the 9.5-year review period, 383 children presented with trampoline-related injuries: 193 (50.4%) were female. Just over a quarter (n = 106, 27.7%) were treated and discharged the same day. The remaining patients accounted for 725 hospital bed days with a mean length of stay of 2.3 days. The most common area of the body injured was the upper limb (n = 246, 64.2%), with a fall from the trampoline to the ground being the most frequent mechanism of injury (n = 257, 67.1%). The majority (n = 345, 90.1%) of children were injured in their home or at the home of a friend or relative. Surgery was required in 236 (61.6%), with closed reduction of an upper limb fracture being the most common procedure (n = 107, 27.9%).

CONCLUSIONS

Trampoline-related injuries remain common in children. Implementation of current guidelines and the introduction of innovative trampoline designs should reduce the risk of this injury in children.

[Supracondylar fractures of the humerus in children]

BACKGROUND

Supracondylar humerus fractures are common in children. Severe complications are rare. We present an overview of treatment options and prognosis.

MATERIAL AND METHODS

The article is based on a non-systematic search in PubMed and experience from our own clinical research.

RESULTS

The injury is usually caused by falling from a height with the arm in extension. The mean age is about 6 years. Undisplaced fractures are treated conservatively with a cast. Displaced fractures should not be treated with a cast alone, as this may cause malunions and permanent neurovascular complications. The rate of complications after traction of displaced fractures is substantially lower than for immobilisation in cast alone. Traction and percutaneous pinning yield similar results, but percutaneous pinning is less expensive--mainly because it shortens the hospital stay. In addition, the risk of cubitus varus deformity seems to be reduced. Today the treatment of choice is closed reduction and percutaneous pinning. Choice of pin configuration is at the surgeon's discretion. Crossed pins are more common than two lateral pins, although medial pins can affect the ulnar nerve. However, the affection is almost always transient. Deep infection after percutaneous pinning is very rare.

INTERPRETATION

Percutaneous pinning of displaced supracondylar humerus fractures in children is cheap and the results are good.

Trampolining injuries

Trampoline-related injuries have increased dramatically over the last few years. This article presents a review of the literature summarizing the different types and mechanisms of sustaining such injuries and looks at current recommendations to prevent them.

Trampoline-related injuries in childhood

Recommendations to prevent trampoline injuries were given since the 1970s. However, despite these educational efforts, safety recommendations seem to be ignored and the number of trampoline injuries is increasing. All children referred to our department for injuries related to trampolines over a period of 3 years were included. The patients' records were reviewed and a questionnaire was sent out in order to gain additional information. Injuries were classified as severe and mild. A total of 265 children (46% m, 54% f) with a median age of 8.2 years (range 1 to 14) were included. The injury rate was continuously growing from the year 2005 (10.6%) to 2007 (58.1%). Most of the injuries were recorded between April and September with a peak of injuries in August. Seventy-five percent of all accidents happened in the afternoon; 40% of the injuries were classified as severe, 60% as mild. Nets or equal security devices were used in 56.6%. Trampolining is associated with a significant risk for bodily harm at any age and results in severe injuries in 40% of cases. Though there may be still room for improvement in safety recommendations, all attempts over a period of more than 30 years to reduce the number of trampoline-related backyard injuries failed and the incidence is still increasing. At present, trampolines cannot be made safe for recreational activities and are of an unacceptable risk even under supervision.

Inflatable bouncer-related fractures in children

BACKGROUND

Inflatable bouncers or moonbouncers are very popular in private and public settings and are usually perceived as very safe attractions, but are associated with frequent fractures in children. To date, there are no publications in the medical literature about these types of injuries. The purpose of this study was to show skeletal injuries related to inflatable bouncer use, describe their characteristics, and determine possible risk factors and preventive measures.

METHODS

Demographic data and injury characteristics were analyzed for all patients who were treated for inflatable bouncer-associated injuries in the pediatric fracture clinic of a level I trauma center from October 2002 to March 2007.

RESULTS

Forty-nine patients were treated for inflatable bouncer-related fractures. Children ranged in age from 1.5 to 15 years old (mean age, 7.8 years) with a male-female ratio of approximately 3:1. The most commonly injured region was the upper extremity (65.5%, n = 32). The most commonly injured area was the elbow (31%, n = 15), and the most common single diagnosis was supracondylar humerus fracture (22%, n = 11). Diaphyseal long bone fractures were found in 18% (n = 9) of the patients and nondiaphyseal in 71% (n = 35). One patient (2%) had an open fracture. Mechanisms of injury included collision of 1 person with another (67%), falling out of a bouncer onto a hard object outside the device (19%), and twisting motion to the leg (14%). There was no adult supervision in many of the incidents (43%), and the presence of different-aged children inside the jumper took place in 52% cases.

CONCLUSIONS

Inflatable bouncers can cause serious orthopaedic injuries. Children playing in the bouncer should be placed in small groups according to their size and should be closely supervised at all times.

STUDY DESIGN

Case series. Level IV evidence.