Monkey Bars Research Articles

The Effects of the COVID-19 Pandemic on Pediatric Orthopedic Injuries: A Single-Center Retrospective Study.

The COVID-19 pandemic has had a profound effect on the pediatric population worldwide. The consequences of the lockdown and the reallocation of hospital resources have caused notable changes in the presentation of pediatric orthopedic injuries. Through our use of patient records, we were able to display the epidemiological trends, as well as analyze the changes in the type and mechanism of various injuries. Our purpose is to further understand the considerable effects of the COVID-19 pandemic on pediatric orthopedic trauma and help guide the allocation of future healthcare resources. We conducted a retrospective cohort study on pediatric patients admitted for any orthopedic injury over a 3-year period (September 2018 to August 2021) at a Midwest level 1 trauma center. Cases were stratified into two groups based on the United States' COVID-19 lockdown (19 March 2020): Pre-COVID-19 cases were any cases prior to the lockdown and Intra-COVID-19 which are cases following the lockdown. Numerical data and categorical variables were summarized and differences between the case groups were examined using either two-Proportion Z-Test, Independent Two-Sample t-test, Pearson's chi-squared, or Fisher's exact tests. A total of 3179 pediatric orthopedic referrals occurred between the Pre-COVID-19 and Intra-COVID-19 study periods. We observed a general decrease in orthopedic injuries following the COVID-19 lockdowns with 1235 injuries compared to 1606 Pre-COVID-19. Patterns in the locations of injuries changed; notably, fractures of the humerus, tibia, and fibula decreased significantly (p < 0.05). Several mechanisms of injuries decreased significantly following the onset of COVID-19 including injuries caused by monkey bars, basketball, and automobiles (p < 0.01). There was a significant increase in the overall injury severity during the Intra-COVID-19 period (p < 0.05). Although there was a reduction in acute orthopedic trauma referrals, many injury mechanisms displayed similar trends regardless of restrictions. We clinically observed an overall increase in the severity of pediatric orthopedic injuries during the COVID-19 pandemic.

Commemorating the monkey bars, catalyst of debate at the intersection of human evolutionary biology and public health.

Play is an essential part of childhood, and growing attention has focused on the potential health benefits of 'risky' or 'thrill-seeking' play. Such play behavior is readily observed on any playground, where it can sometimes lead to injuries--most often from fall impacts--that require medical attention. Monkey bars account for ~7% of childhood arm fractures in the USA, an alarming statistic that raises difficult questions over its costs and benefits. Many authors view monkey bars as a public health hazard, but it is plausible that our childhood impulse toward thrill-seeking play is a result of selective pressures throughout our primate evolutionary history. Indeed, emerging evidence suggests that the developmental benefits of thrill-seeking play extend into adulthood, outweighing the occasional costs of injury. Disparate and consequential, these dueling perspectives have fueled debate among health professionals and policymakers, but with little attention to the work of biological anthropologists. Here we call attention to the hominin fossil record and play behaviors of non-human primates, providing a novel perspective that bolsters arguments for the adaptive significance of thrill-seeking play. The moment for such a review is timely, for it commemorates the centennial anniversaries of two playground icons: the jungle gym and monkey bars.

Monkey bars and medical masks: a photo-voice study of children’s playground safety in British Columbia, Canada

ABSTRACT Children’s perspectives on their outdoor play safety can provide unique insight into what activities and environments are injurious for them. In this study, we conducted photo-elicitation interviews with 13 children (7 girls, 6 boys) from low- to mid-income communities who were between the ages of 9- to 13-years-old. The goal of the study was to examine their perspectives of outdoor play safety around urban playgrounds over a two-week period while they participated in day camp activities. Our thematic content analysis resulted in three themes: (1) fear of falling; (2) illness prevention; and (3) need for excitement. Our findings suggest children’s perception of safe play may be shaped by exposure to sanitary practices throughout the COVID-19 pandemic. Further, findings demonstrate children can experience tensions in participating in desirable play that is exciting, novel, and challenging, while fearing they could fall from higher structures that afford them with these opportunities.

Monkey Bar-Associated Pediatric Fractures: A National Epidemiologic Study of Emergency Department Visits.

Emergency department (ED) visits because of pediatric fractures are not only burdensome for patients and their families but also result in an increased healthcare expenditure. Almost half of all children experience at least one fracture by the age of 15. Many fractures occur in playgrounds, with monkey bars and other climbing apparatuses noted as frequent mechanisms of injury. Our purpose was to identify the pattern of injury and the population sustaining monkey bar-associated fractures. We queried the National Electronic Injury Surveillance System database for all monkey bar-associated injuries in patients aged 0 to 18 years from January 1, 2009, to December 31, 2019. We described demographic data, patient disposition from the ED, fracture pattern, and injury setting using unweighted and weighted estimates. Weighted results that more closely reflect national estimates were calculated. During the study period, 30,920 (862,595 weighted) monkey bar-associated injuries presented to EDs; 16,410 (53.1%) (weighted injuries: 408,722 [47.4%]) were fracture injuries. The average age of kids sustaining fractures was 6.5 years, with most injuries (66.4%) occurring in kids between 6 and 12 years. A higher percentage of male patients presented to the ED with fractures compared with female patients (53% versus 47%). Upper extremity fractures were most common, 382,672 (94%) with forearm fractures constituting the majority (156,691 [38%]). Most children were treated and released (354,323 [87%]), with only 35,227 children (9%) being admitted for treatment. Places of recreation/sports were the most common setting of fractures (148,039 [36%]), followed by schools (159,784 [39%]). A notable association was observed between year and ethnicity and between month period and injury setting. Monkey bar-associated injuries are a major cause of upper extremity fractures in children, with most injuries occurring in recreational areas or schools. Young elementary school children are at the highest risk of injury. ED visits because of monkey bar-associated fractures have increased over the study period, and these injuries continue to be a major cause of fractures in children. Additional measures should be installed to decrease these preventable fractures among children, with schools as a potential starting point.

Admission of Upper Extremity Injuries Presenting to the Emergency Department: An NEISS Study.

Upper extremity injuries account for 36.5% of presentations to the emergency department in the United States. This study seeks to determine current rates of upper extremity injuries that present to the emergency department and the injury characteristics of patients requiring admission. National Electronic Injury Surveillance System was queried for a 10-year period for upper extremity injuries. Further analysis was done to evaluate specific patient demographics, injury characteristics, and mechanisms of injury of those patients who were admitted to the hospital. Between 2012 and 2021, 39 160 365 persons are estimated to have presented to 100 United States emergency departments for managing upper extremity injuries, accounting for 28.8% of total presentations. A total of 12 662 041 upper extremity patients were pediatric (32.3%). Admissions occurred in 4.6% of presentations. The most common presenting diagnosis was laceration (24.9%), while the most common admission diagnosis was fracture (49.7%). The majority had injuries involving their forearms (19.9%). The most common injury-associated consumer product group was stairs, ramps, landings, and floors at 28.5%. Of the 445 644 patients, those estimated to have been injured by stairs, ramps, landings, and floors adults were 429 435 or 96.4%. The most common injury-associated product in pediatric populations was playground equipment (23.6%), of which 53.7% was from monkey bars and other climbing apparatuses. This study demonstrates an overall increase in admissions for upper extremity injuries in the setting of similar rates of overall upper extremity injuries with fractures and forearm being the most common diagnosis and body part involved, respectively. IV; Database.

Open Reduction of Pediatric Femur Fracture: A Technical Trick

Open Reduction of Pediatric Femur Fracture: A Technical Trick

AcroMonk: A Minimalist Underactuated Brachiating Robot

Brachiation is a dynamic, coordinated swinging maneuver of body and arms used by monkeys and apes to move between branches. As a unique underactuated mode of locomotion, it is interesting to study from a robotics perspective since it can broaden the deployment scenarios for humanoids and animaloids. While several brachiating robots of varying complexity have been proposed in the past, this paper presents the simplest possible prototype of a brachiation robot, using only a single actuator and unactuated grippers. The novel passive gripper design allows it to snap on and release from monkey bars, while guaranteeing well defined start and end poses of the swing. The brachiation behavior is realized in three different ways, using trajectory optimization via direct collocation and stabilization by a model-based time-varying linear quadratic regulator (TVLQR) or model-free proportional derivative (PD) control, as well as by a reinforcement learning (RL) based control policy. The three control schemes are compared in terms of robustness to disturbances, mass uncertainty, and energy consumption. The system design and controllers have been open-sourced <xref ref-type="fn" rid="fn1" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">¹</xref> <fn id="fn1" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><label>¹</label> The open-source implementation is available at <uri>https://github.com/dfki-ric-underactuated-lab/acromonk</uri> and a video demonstration of the experiments can be accessed at <uri>https://youtu.be/FIcDNtJo9Jc</uri>. </fn> Due to its minimal and open design, the system can serve as a canonical underactuated platform for education and research.

New Injury Patterns in Pediatric Supracondylar Fractures During COVID-19: Beds Are the New Monkey Bars.

The coronavirus disease 2019 (COVID-19) pandemic drastically altered children's activity patterns. Our goal was to investigate how COVID-19 affected demographics, injury characteristics, treatment patterns, follow-up, and outcomes in pediatric supracondylar humerus (SCH) fractures. This was an Institutional Review Board-approved retrospective analysis of patients undergoing surgery for a SCH fracture from May to November 2019 (pre-COVID-19) and from May to November 2020 (during COVID-19) at 2 tertiary children's hospitals. Demographic information, injury characteristics, hospital course, and follow-up data were collected and compared. SCH fractures decreased by >50% from 2019 (149) to 2020 (72). Children in the 2020 cohort were younger (mean 5.2y old) compared with 2019 (6.0y old) ( P =0.019). Mechanism of injury was significantly different in 2020 ( P <0.001), as the proportion of trampoline and furniture fractures increased from 8% and 17% to 15% and 33%, respectively. The proportion of playground and monkey bar fractures decreased from 20% and 17% to 3% and 4%, respectively. Distribution of Gartland type and neurovascular injury rates were similar in 2019 and 2020 ( P =0.411 and 0.538). Time from emergency department admission to the operating room and duration of hospital admission were both unchanged from 2019 to 2020 ( P =0.864 and 0.363). The duration of postoperative follow-up in 2019 was 94.5 days compared with 72.8 days in 2020 ( P =0.122), as more pandemic patients were lost to follow up (22.5% vs. 35.2%, P =0.049). The demographics, mechanism of injury, and follow-up practices of pediatric SCH fractures changed significantly during the pandemic, likely because of school closures and lock-downs changing activity patterns. Different mechanisms of injury affected younger patients and reflected the new ways children played. Trampoline-related and furniture-related injuries overtook the classic playground falls as primary mechanism of injury. Despite the need for COVID-19 testing, there was no delay in time to the operating room. Hospitalization duration did not change, yet postoperative follow-up was shorter, and more patients were lost to follow up. Despite these stressors, outcomes remained excellent in most children. Level III-Retrospective comparative study.

Risk Factors for Upper Extremity Refractures in Children.

Multiple descriptive studies have been published on refracture patterns, particularly for forearm fractures. However, few large cohorts have been analyzed quantitatively including the odds of refracture, and with a comprehensive assessment of the possible predictive factors associated with refracture. This study aimed to assess the frequency and timing of upper extremity refracture in a large pediatric orthopaedics practice, and to evaluate the strength of association of various patient-level and fracture-related factors with refracture. Medical records were reviewed retrospectively for patients 1 to 18 years of age with at least 1 upper extremity fracture (ICD-9 codes 810 to 819) between June 1, 2010 and May 31, 2011. Characteristics of patients and fractures were assessed for the association with refracture using bivariate analysis and multivariable logistic regression. Among 2793 patients with a total of 2902 upper extremity fractures, 2% were treated for refracture within 2 years, at a median of 6 months (188d) after the initial injury. Midshaft location, and characterization of the fracture as angulated or buckle, were associated with being more likely to refracture. Eighty percent of refractures were the result of a fall, with almost 25% involving a high-energy mechanism and about 15% from monkey bars or other playground equipment. The adjusted odds of refracture were 4 times higher if noncompliance with treatment recommendations was documented, when controlling for insurance type and number of days before orthopaedic evaluation. Forearm fractures were almost 4 times more likely to refracture compared with other bones, controlling for midshaft location, days immobilized, and buckle or torus characterization of the fracture. Our practice saw a refracture occurrence in 2% of patients, with median time to refracture of ~6 months. The factors most strongly associated with refracture were midshaft fracture location, forearm fracture as opposed to clavicle or humerus, and noncompliance as defined in the study. Falls and high energy activities, such as use of wheeled devices, skis, or trampolines, were important mechanisms of refracture. This study is a Level II prognostic study. It is a retrospective study that evaluates the effect of patient and fracture characteristics on the outcome of upper extremity refracture.

Incidence of flexion-type supracondylar fractures at a single Australian level one Paediatric Trauma Centre.

BackgroundSupracondylar fractures are the most common elbow fracture. There have been no studies published analysing flexion‐type fractures in the Australian paediatric population. This paper aims to investigate flexion‐type supracondylar fractures in an Australian paediatric population. Eight hundred and three paediatric supracondylar elbow fractures were retrospectively reviewed at one hospital over a 5 year time period. The focus was on flexion‐type fractures.MethodsSupracondylar fractures that presented to the Women's and Children's Hospital Emergency Department between 2015 and 2020 were retrospectively reviewed. Fractures were classified on plain radiographs according to the Modified Gartland Classification System. Injury and treatment data were collected for flexion‐type fractures.ResultsTwenty‐one (2.6%) of fractures were flexion‐type. The average age of injury was 6.8 years old. Flexion‐type fractures were more common in females (62%) and with high energy mechanisms (81%). Ulnar nerve palsies occurred in five cases (24%). Two ulna nerve palsies did completely resolve at 3 months follow up. One open fracture occurred. No vascular injuries occurred. Ten of the 21 flexion‐type fractures (48%) were treated surgically.ConclusionsThe authors conclude that: flexion fractures are uncommon, they occur more often after high energy mechanisms such as falls from monkey bars, swings, or trampolines. Flexion‐type fractures occur more often in slightly older females. The ulnar nerve is most frequently injured and in the current study—exclusively injured. At 3 month follow up, spontaneous nerve recovery had occurred in three of the five cases (60%).

Branchflows: Upside-Down Rivers Clinging to the Bark Above Our Heads

If you look up during a storm or when it is foggy, you may see little rivers flowing down the tree branches above your head. These are called branchflows, and they play an important part in moving water along trees and through forests. For scientists who study water, branchflows are really weird! They do not flow on top of something, like rivers that flow over the ground. Instead, they flow underneath branches, clinging to the bark, the same way you might cling to monkey bars at the park. Branchflows can also disappear before making it to the ground, because the water gets stuck inside of tree holes. Branchflows transport important stuff through the forest and to the forest floor, from life-saving meals to life-ending predators! Please join us as we explore what branchflows are, where they flow, what they carry, and why we need to know more about them.

Elbow Injuries in Children

Elbow Injuries in Children

COVID-19 pandemic restrictions unmasks dangers of frequent injury mechanisms for common surgically treated pediatric fractures.

Purpose:This study examined the volume and characteristics of common surgically treated fractures in children during the COVID-19 pandemic. The worldwide spread of COVID-19 affected the society in numerous ways. Social distancing led to changes in the types of activities performed by individuals, including children. Physicians saw a shift in orthopedic trauma volume and distribution. We predicted that with the change in activities children participated in, the number or type of injuries sustained would change as well.Methods:A retrospective review was performed of children who sustained a surgically treated fracture of the forearm, supracondylar humerus, femur, or any open fracture during the COVID-19 pandemic compared to the previous 2 years (pre-pandemic). Patient demographics, insurance status, and mechanism of injury were recorded. Statistical analysis was performed.Results:Review of the medical records identified 791 children. The number of fractures decreased from an average of 295 per year pre-pandemic to 201 during the pandemic (p = 0.09). During the pandemic, there was a decrease in injuries resulting from a fall from the monkey bars for supracondylar humerus (21.2% to 8.2%, p < 0.01) and for forearm fractures (15.5% to 4.3%, p = 0.04). In contrast, the frequencies of falls from a skateboard, hoverboard, scooter, or bicycle and falls from household furniture increased during the pandemic.Conclusion:The observed decrease in monkey bar–related injuries provides further evidence as to the dangers of this piece of playground equipment in contributing to upper-extremity fractures in children.Level of evidence:Level III: Prognostic and Epidemiological.

Bangkok, and: Clutch

Bangkok, and: Clutch Kai Coggin (bio) Bangkok i Nothing of Bangkokresounds in my bones,no smells,no sounds,no images etched onto rice paper memory,the passing lightof Gleaming Golden Imperial Dragon Bargesgliding down the murky central khlong,the dirty river marketplace of softened producesold from leathered old women in congested tiny boats.The Golden Barges of the King making waves,rocking floating fruit huts, souring in the heat. Nothing of this is from my memory—I am putting together pieces as I write,and creating a scene in my mindthat is dressed like a memory,but Bangkok may as well be Alaskacold in its un-remembrance,like I was never even there,like I was not bornat (King Chulalongkorn Memorial Hospital)on the first day of the year,on the first year of the decade,the first child in a marriage that held desperately to lasting. [End Page 146] ii Trauma does funny things to memory—inserts clouded grey areas,sometimes over whole years,loses connections to colors, sounds,but I know from pictures that I wore adi√erent colored gingham-print dress to school every day,Monday was green, or Tuesday blue,I know for sure Friday was yellow,I always loved the yellow dress becausethe yellow and white blended into something like sunshineand didn’t look so … gingham,and Friday was yellow, or Thursday,and my face looks so happy,I can almost smell the rust on those monkey bars,but don’t remember that I could climb them. iii When Bangkok was rippedout of my seven-year-old handsand my father went away with my country,I dropped all my memories out of a tiny hatchin the airplane headed for America,just let them slip from my tiny fingers,underneath my oversized seat,each one falling through the life preserver,through the cold cloud-covered metal of the airplane bellyand into the oblivion of skyand the widest ocean I have ever seen,but don’t remember seeing. [End Page 147] Clutch (after Diane Seuss) I drive to a playground most likely and just listen to them laugh,watch as they spark conversations with each other, melt insideat imagination leading and questions not far behind, they glowoutside of me, and my womb is an empty field of bleeding hearts.If there is truly the taste of regret stirred into this poem, it is warm milkleaking from my breast into nothing’s mouth, it is hands formedinto cradle rocking no one, back and forth, my lips forming silentsongs lullabying goodbyes to whom was never born into hello.I drive to a playground most likely, walk toward the whimsy of their day,sit on a small horse on a fat metal spring, and sway like a ghost.This is the road of regret that leads to the grass underfoot of ache,the sigh of tomorrows empty of growing, the cycles of my uncreated childrenstill sitting somewhere as stardust, hovering over me waitingfor the clutch of my hand to break through the sky. [End Page 148] Kai Coggin Kai Coggin (she/her) is the author of four poetry collections, most recently Mining for Stardust (FlowerSong Press, 2021) and INCANDESCENT (Sibling Rivalry Press, 2019). She is a queer woman of color who thinks Black Lives Matter, a teaching artist in poetry with the Arkansas Arts Council and Arkansas Learning Through the Arts, and host of the longest running consecutive weekly open mic series in the country—Wednesday Night Poetry. Recently awarded the 2021 Governor’s Arts Award, named “Best Poet in Arkansas” by the Arkansas Times, and nominated as Hot Springs Woman of the Year, her fierce and powerful poetry has been nominated four times for the Pushcart Prize, as well as Bettering American Poetry 2015, and Best of the Net 2016, 2018, 2021—awarded in 2022. Her poems have appeared or are forthcoming in POETRY, Best of the Net, Cultural Weekly, SOLSTICE, Bellevue Literary Review, TAB, Lavender Review, Tupelo Press, West Trestle Review, and elsewhere. Coggin is associate editor at the The Rise Up Review, and serves on...

Paediatric elbow fractures and public play spaces: adherence to standards for children’s playground equipment and surfacing

BackgroundSupracondylar humerus fractures (SCHF) are the most common fractures sustained following a fall onto an outstretched hand among healthy children, and one of the leading causes of hospital admission and...

Too far to fall: Exploring the relationship between playground equipment and paediatric upper limb fractures.

Playground equipment, most notably monkey bars, appears to be involved in a high proportion of upper limb fractures (ULFs) in the Australian paediatric population. Despite this, in 2014, Australian playground standards increased the maximum acceptable 'free height of fall' playground equipment from 2.5 to 3.0m, and maintained monkey bars at 2.2m. An updated snapshot regarding playground ULFs since these changes is important. This study aimed to determine the number and severity of playground ULFs in a paediatric population, compared to other common activities involved in ULFs. Records of all patients aged 0-17 presenting to the Austin Hospital Paediatric Emergency Department with ULFs over a 12-month period were analysed retrospectively. ULFs included fractures to the carpal bones, radius, ulna or humerus. Variables documented included the activity involved with the fracture, and fracture management. Results were analysed using descriptive statistics. A total of 725 ULF cases were collected. Playground equipment was involved in 23% (n=162/697, missing n=28) of fractures. Monkey bars were involved in 14% of fractures (n=100/697, missing n=28), 1.64 times more than the next most common activity. Monkey bars were involved in 62% (n=100/162) of all playground fractures. In children aged 5-9, monkey bars were involved in 27% (n=83/304) of ULFs. Monkey bars were furthermore involved in most cases of 'severe' fractures (requiring reduction/operation) (n=33), with one-third of monkey bar fractures being severe. Given these findings, the authors recommend a renewed focus on measures that reduce the frequency and severity of falls from monkey bars.

Fracture Clinic

A certainty every spring is that warmer weather brings green grass, blooming flowers, monkey bars, trampolines and —pediatric fractures! With our trauma clinics starting to fill up, the aim of this installment of the JPOSNA “Coding Corner” is to equip you with the most up-to-date knowledge regarding fracture documentation and billing.

Playground equipment-related extremity fractures in children presenting to US emergency departments, 2006\u20132016

BackgroundDespite updated playground equipment and improved industry standards, playgrounds remain a common source of childhood injury. Fractures account for 35% of all playground injuries presenting to emergency departments (EDs). We aimed to examine the time trends and epidemiologic patterns of playground equipment-related extremity fractures in children in the United States.MethodsWe analyzed data from the National Electronic Injury Surveillance System. Children ≤14 years presenting to US emergency departments from 2006 to 2016 with playground equipment-related injuries were included. We used weighted complex survey analysis to describe the epidemiologic patterns and severity of playground equipment-related extremity fractures and Joinpoint linear weighted regression analysis to determine trends in extremity fractures.ResultsAn annual average of 72,889 children were treated in US EDs for playground equipment-related extremity fractures, yielding a national annual incidence rate of 119.2 per 100,000 children. Playground equipment-related extremity fractures accounted for 33.9% of ED presentations and 78.7% of hospitalizations for playground equipment-related injuries. Of patients with playground equipment-related extremity fractures, 11.2% had severe fractures requiring hospitalization. The annual rate of ED visits due to playground equipment-related extremity fractures remained stable (annual rate of change = 0.74, p = 0.14) from 2006 to 2016. Adjusted for age, injuries on monkey bars or climbing gyms were associated with significantly increased odds of extremity fractures in comparison to injuries from other playground equipment (adjusted odds ratio [aOR]: 2.0; 95% CI: 1.9–2.1). Overall, 49.8% of extremity fractures and 54.7% of severe extremity fractures (i.e. those requiring hospitalization) occurred on monkey bars or climbing gyms.ConclusionsDespite enhanced playground safety standards, national rates of playground equipment-related extremity fractures have remained stable in the US. Extremity fractures remain the most common type of playground injury presenting to EDs and most commonly occur on monkey bars and climbing gyms.

Fast and flexible multilegged locomotion using learned centroidal dynamics

We present a flexible and efficient approach for generating multilegged locomotion. Our model-predictive control (MPC) system efficiently generates terrain-adaptive motions, as computed using a three-level planning approach. This leverages two commonly-used simplified dynamics models, an inverted pendulum on a cart model (IPC) and a centroidal dynamics model (CDM). Taken together, these ensure efficient computation and physical fidelity of the resulting motion. The final full-body motion is generated using a novel momentum-mapped inverse kinematics solver and is responsive to external pushes by using CDM forward dynamics. For additional efficiency and robustness, we then learn a predictive model that then replaces two of the intermediate steps. We demonstrate the rich capabilities of the method by applying it to monopeds, bipeds, and quadrupeds, and showing that it can generate a very broad range of motions at interactive rates, including banked variable-terrain walking and running, hurdles, jumps, leaps, stepping stones, monkey bars, implicit quadruped gait transitions, moon gravity, push-responses, and more.

Monkey Bar Dimensions Associated with Pediatric Upper Extremity Fractures Show Deviations from United States Product Safety Commission Recommendations.

BackgroundMonkey bar injuries account for the majority of playground injuries, and 34% result in a fracture. Studies have shown that there has been no decline in the number of monkey bar injuries over several decades. Our goal was to focus on fractures of the upper extremity resulting from monkey bar injuries. Additionally, we set out to analyze the dimensions of the monkey bar apparatus on which the injury occurred and determine if they were compliant with those recommended by the United States (US) Product Safety Commission.MethodsA retrospective chart review of all upper extremity injuries seen in a large pediatric orthopedic practice in 2017 was conducted to find all monkey bar-related injuries. Data was collected including age at the time of injury, gender, and injury type. Families of the injured child were contacted to identify the exact location of the injury. On-site measurements were made of the monkey bar apparatus including height, the distance between grips, the circumference of the grip, and ground surface type.ResultsOf 1968 patients seen in 2017, there were 990 upper extremity injuries and 66 monkey bar injuries (98.5% fractures). The average age of those injured on monkey bars was 6.6 ± 1.9 years, 60.6% were males. The average height of the apparatus was 207.32 ± 16.59 cm (range: 176.53-254 cm), the average distance between grips was 35.30 ± 5.62 cm, and the average circumference of the grip was 9.83 ± 1.03 cm. All exceeded the recommended height for preschool children aged 4-5 years (152.4 cm), and 11 of the 30 (36.7%) exceeded this recommended height for school-age children (213.26 cm). For the distance between grips, 23 of the 30 (76.7%) exceeded the preschool recommendation (30.48 cm), and three of 30 (13.3%) monkey bars exceeded the recommendation for school age children (38.1 cm).ConclusionMonkey bar injuries continue to be a common source of upper extremity fractures among young children. There is a high rate of non-compliance with current recommended safety standards.