Heridas ortopédicas asociadas con el uso de trampolín de patio en niños. (Ingl.)

Abstract

In this report, the authors reviewed the backyard trampoline orthopedic injuries in children admitted to the Winnipeg Children’s Hospital. They made up 1.6% of all trauma admissions. The charts, x-rays, and operative reports for 80 children (40 boys and 40 girls), from 2 to 15 years (mean, 9 years, with 18% between 2 and 4 years and 49% in the 5 to 9 years age group) were reviewed, covering January 1996 to October 1997 (21 months). They noted the mechanism, type, severity, and treatment of the orthopedic injury. Fifty-two (65%) children were injured on the trampoline mat, and 24 (30%) were injured when they were ejected from the trampoline. Sixty (75%) children sustained a fracture or fracture/dislocation, and 25% reported only soft-tissue injury. Forty-eight (80%) of these orthopedic injuries occurred in the upper extremity. Not surprisingly, most (74%) injuries occurred during the summer months (June to September), and the majority (51%) were at a neighbor’s home. One third said the injury occurred when they were alone on the trampoline, whereas 35% sustained their injury while on the mat with 1 to 5 other children, although the actual incidence may have been underestimated, as reported by others. In only 10% of cases was an adult “supervising” the trampoline use. Nonetheless, the authors speculate that because most children sustained their injury from a simple fall on the mat even with adult supervision, the injury may not have been preventable. A number of children were injured throught imaginative uses of the trampoline (eg, jumping from the roof onto the trampoline). These innovative mechanisms might have been preventable had adult supervision been available. The most common fracture sites were the forearm (45%) followed by the humerus and elbow (35%); supracondylar fractures (81%) and fracture-dislocations of the elbow accounted for the 21 injuries, about and above the elbow. There were no associated vascular injuries and no knee dislocations. The most serious injury was a fracture-dislocation of the cervical spine, with paralysis, in an 8 year old boy, who was ejected from the mat. There were no deaths. The rare deaths that did happen in the 1996 statistics from the Consumer Product Safety Committee in the United States (US) were all secondary to severe head and neck trauma. The Canadian Hospital Injury Reporting and Prevention Program, (a computerized information database) records injuries in children’s hospitals in Canada. In 1996, 1,042 trampoline injuries in children were seen in emergency departments: (36% fractures, 12% involved head and neck, 64% occurred on home trampolines). There were several limitations to this study, according to the authors: (1) It was a retrospective study. (2) They could not obtain information on the number of and overall use of trampolines in Winnipeg; therefore, no conclusion could be made about the relative risk of injury from the backyard trampoline versus other childhood activities. 3. Because histories were obtained from the injured child or witnesses of similar age, a reporting bias may have been present. Finally, the authors suggested the following guidelines for the use of backyard trampolines: (1) Physicians should advise children and their families of the potential dangers of trampoline use, (2) children younger than 6 years should not use the trampoline, (3) children should not use the trampoline without adult supervision, (4) no more than 1 person should be on the trampoline at any time, (5) no flips or other advanced maneuvres should be attempted. In children, a trampoline is a high-risk activity, and the backyard trampoline has the potential for significant orthopedic injury.—Sigmud H. Ein.

Journal of Pediatric Surgery. April 2004. Volume 39. Number 4.

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