Trampoline Injuries Research Articles

MR imaging for detection of trampoline injuries in children

BackgroundThe recreational use of trampolines is an increasingly popular activity among children and adolescents. Several studies reported about radiological findings in trampoline related injuries in children. The following publication presents our experience with MRI for detection of trampoline injuries in children.Methods20 children (mean 9.2 years, range: 4–15 years) who had undergone an MRI study for detection of suspected trampoline injuries within one year were included. 9/20 (45%) children had a radiograph as the first imaging modality in conjunction with primary care. In 11/20 (55%) children MR imaging was performed as the first modality. MR imaging was performed on two 1.5 T scanners with 60 and 70 cm bore design respectively without sedation. In 9/20 (45%) children the injury mechanism was a collision with another child. 7/20 (35%) children experienced leg pain several hours to one day after using the trampoline without acute accident and 4/20 (20%) children described a fall from the trampoline to the ground.ResultsAll plain radiographs were performed in facilities outside the study centre and all were classified as having no pathological findings. In contrast, MR imaging detected injuries in 15/20 (75%) children. Lower extremity injuries were the most common findings, observed in 12/15 (80%) children. Amongst these, injuries of the ankle and foot were diagnosed in 7/15 (47%) patients. Fractures of the proximal tibial metaphysis were observed in 3/15 children. One child had developed a thoracic vertebral fracture. The two remaining children experienced injuries to the sacrum and a soft tissue injury of the thumb respectively. Seven children described clinical symptoms without an overt accident. Here, fractures of the proximal tibia were observed in 2 children, a hip joint effusion in another 2, and an injury of the ankle and foot in 1 child. There were no associated spinal cord injuries, no fracture dislocations, no vascular injuries and no head and neck injuries.ConclusionsIn the majority of children referred for MR imaging with pain after trampoline MR imaging detects injuries. These injuries are often not visible on plain radiographs. Therefore we recommend a generous use of MR imaging in these children after initial negative plain radiography.

Garden hazards: trampoline injuries.

Trampolining is more popular than ever, but it can also cause injuries, some of them very serious. Siba Prosad Paul, Torbay Hospital, Torquay, Joanna Barnden, University of Bristol, and Meridith Kane, Yeovil District Hospital, discuss what can be done to prevent them.

Pediatric Fractures Secondary to Trampoline Injury: A Prospective Analysis of User Circumstances and Injury Severity with Respect to American Academy of Pediatrics Policy Statement

Pediatric Fractures Secondary to Trampoline Injury: A Prospective Analysis of User Circumstances and Injury Severity with Respect to American Academy of Pediatrics Policy Statement

The 'trampoline ankle': severe medial malleolar physeal injuries in children and adolescents secondary to multioccupant use of trampolines.

The purpose of this study was to describe a series of patients presenting with medial malleolus Salter-Harris types III and IV fractures (MacFarland fractures) related to trampoline use. In total, 11 patients were reviewed retrospectively (mean age: 11.8 years; four boys and seven girls). Salter-Harris type III fractures were more commonly seen (n=7). Undisplaced fractures were more prevalent (n=6). Six children underwent surgical treatment. Average follow-up time was 17.8 months. A medial physeal bar with subsequent growth arrest and ankle deformity was observed in two patients. More than one user was present on the trampoline at the time of the injury in nine of the reported cases. Medial malleolus growth-plate injuries can be seen after trampoline injuries where multiple users were involved. Potential complications including growth arrest can occur.

Australian trampoline injury patterns and trends

Objectives:To examine national trampoline injury patterns and trends in the context of improved product safety standards and trampoline design modifications. Method:Review of National Hospital Morbidity data. Results:There were an average 1,737 trampoline injuries reported nationally each year from 2002 to 2011. Both injury frequency and rate grew. Statistically significant rate increases were observed among all age groups, although both are highest among children aged 5–9 years. From 2008/09 there is a possible decreasing trend among the 5–9 age group. Falls predominate and 81% of falls result in fracture. Non‐fall injuries increased annually as a proportion of all hospitalised injury although they did not comprise more than 2.4% in any one year. Conclusions:History provides no evidence of an observable effect of voluntary Australian Standards for trampoline safety on population rates for trampoline injury. The major design modification – netted enclosures – could contribute to the risk of injury by leading parents to falsely believe that a netted enclosure eradicates the risk of injury.

Let's not forget about injury.

Let's not forget about injury.

Influence of voluntary standards and design modifications on trampoline injury in Victoria, Australia

PurposeTo examine the influence of the voluntary Australian trampoline standard (AS 4989-2006) and market-driven design modifications on relevant trampoline injuries.MethodsTrend and intervention analysis on frequencies and proportions of hospital-treated trampoline-related...

117: Parental Knowledge of Trampoline Safety in Children

Trampoline injuries remain an important pediatric injury necessitating either an emergency department (ED) visit or hospitalization. Parents are in the best position to advocate for the safety of their children during recreational use of trampolines. However, there is no evidence examining parental awareness and application of trampoline-related safety recommendations. In parents of children who presented to the ED with extremity injuries, we determined the proportion of parents who were aware of the five key recommendations for safer recreational trampoline use in children. We also examined parental willingness to allow their children to use a recreational trampoline once informed that national pediatric and orthopedic societies have recommended a ban on home use of trampolines. This was a prospective cross-sectional survey of parents presenting to a tertiary care pediatric emergency department with children 2–17 years of age with an extremity injury. The 24 question survey tool was pre and pilot tested on the target audience for question content and clarity. Assuming a sample proportion of parents who are aware of all five key recommendations to be 0.10, error of +1.5%, α=0.05, a β=0.2 resulted in a sample size of 1400. Of the 1423 enrolled parents, 542 (38.1%) had regular access to a trampoline and 125 (8.8%) of their respective children had a history trampoline injury. Importantly, only 116 (8.2%; 95% CI 6.8 to 9.6) of parents were aware of five key safety recommendations for home trampoline use. Parental knowledge of trampoline safety recommendations was less likely in those whose children had regular recreational trampoline use versus those without (OR =0.6 95% CI 0.4, 1.0), while those parents with children who had a prior trampoline related injury versus those without such injury were more likely to be aware of trampoline safety (OR = 2.3 95% 1.1, 5.1). 96.5% of parents reported that their primary care physician had never discussed trampoline safety with them. Prior to informing parents of the ban recommended by pediatric and orthopedic societies, the proportion of parents willing to own a home trampoline was 30.5%, while after this disclosure willingness decreased to 20.5% (P<0.0001). Trampoline safety knowledge of the five key recommendations among parents is low, but increases with exposure to a trampoline related injury. Parents were less willing to own a home trampoline once made aware of national recommendations. In this population, trampoline safety knowledge was not being discussed preventively in well child visits.

Fractures From Trampolines

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

Trampoline related injuries in children: risk factors and radiographic findings

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. 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. 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. 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.

Difference in injury profile in Trampoline and Artistic Gymnastics

The trampolines and artistic gymnastics have a high incidence and severity of injuries, with many differences in the elements, movements and demands. The purpose of this study was to compare Trampoline and Artistic Gymnastics’ injury profile. The sample was 33 athletes, 80% female and 20% male, 14 artistic and 19 trampolines gymnasts. The mean age was 11 years for artistic and 17,2 years for trampoline gymnasts. The survey was done by analyzing records of competitive level gymnasts, seen in the Physical Therapy Department of a Brazilian private sports club, in 2010. Athletes who suffered no injury, or not sought medical care in physical therapy were not included in the study. The incidence was 84 injuries in gymnastics sports, 27 in artistic and 57 in trampoline, the mean was 1,9 injury per athlete for artistic and 3,0 for trampoline. According the kind, 52% was acute injuries and 48% was chronic, in both modalities; 36% happen in right side, 34% in left side, 5% in both sides and 25% in no specific side. The most common trampoline injury was low back dysfunction (26,3%), and in artistic gymnastic ankle sprains (25,9%). The upper limbs injuries happen often in the artistic gymnasts, especially in the wrist and shoulder (22,2%). Leg injuries, mainly periosthitis, occurred only in trampoline. The most injuries were ligament and tendon in artistic and muscle damage in trampoline. The stress fractures occurred in both types of gymnastics. According to the injury mechanisms, the majority in trampoline was skeletal muscle spasms and in the artistic was nonspecific pain, related to overuse, like tendinitis and joint dysfunctions. The difference between the trampoline and artistic could be seen in the different profile injuries. The upper extremities are used as weight bearing limbs in artistic gymnastics, so high impact loads affect directly wrist and shoulders with specific injuries that occurred only in modality. The low back overload in trampoline is clear with high number of injuries which appear to result from repeated microtrauma caused by repeated jumps. The high incidence in lower limbs is always reported in literature and is supported in this study. Some points are similar, like the proportion between chronic and acute injuries and laterality. The risk of gymnastic injuries seems to be proportional to the level of the athletes, this was is possible to confirm in this study, in trampoline with higher mean age the injuries frequency was bigger than artistic.

TRAMPOLINE INJURY PREVENTION – CAN ‘FALL-OFF’ AND ‘FALL-ONTO’ INJURIES BE ELIMINATED WITH GOOD PRODUCT DESIGN?

BackgroundInjuries from trampoline related accidents place a heavy burden on society directly through suffering among children and adolescents and indirectly via the costs associated with hospital admissions and emergency department...

Safe trampolining—a persistent challenge

BackgroundTrampolines are associated with 1100 hospital-treated child injuries annually in Victoria, almost two-thirds of which occur in home backyards. In the United States the American Academy of Paediatrics called for...

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.

Parallel Plating for a Sternomanubrial Dislocation

Sternomanubrial dislocations are rare injuries. Although few cases of this injury have been reported in the literature, the etiology has varied widely: trampoline injury, seizures, falls from height, sporting injuries, gradual deformities from spine fractures, and motor vehicle collisions. This injury has been classified into 2 types: in type I, the sternal body is displaced posteriorly to the manubrium, and in the more common type II, the sternal body is displaced anteriorly. The sternomanubrial joint is an amphiarthroidal joint that bears hyaline cartilage on both surfaces connected by a fibrocartilage meniscus. It serves a protective role to vital thoracic structures and is an anterior stabilizing strut to the thorax, assisting the thoracic spine in upright stability. It is important to not ignore type I dislocations because posterior sternum displacement is a harbinger of injury to the pulmonary tree, heart, and esophagus. Chronic instability at this joint can lead to dyspnea and dysphasia due to sternum displacement. In the right scenario, type II injuries are occasionally treated conservatively with palliative treatment until the sternum heals with malformation. This article describes the case of a 20-year-old man who was treated surgically for symptomatic type II sternomanubrial dislocation with dual anterior locked plating. Locked plating gives the benefit of unicortical fixation, with the screws and plate acting as a unit to resist motion. Screw pullout and failure is less common, and the construct is more resistant for this application. The patient returned to full participation in activities of daily living and military duty 4 months postoperatively.

The increasing incidence of paediatric diaphyseal both-bone forearm fractures and their internal fixation during the last decade

BackgroundThe incidence of children's forearm fractures is increasing worldwide. This is different from the declining trend observed in the overall injury rate, and the reason for the increase is not known. Diaphyseal forearm fractures comprise 3–6% of all paediatric fractures, and they offer a challenge to their treatment. The purpose of this study was to evaluate the incidence of diaphyseal both-bone forearm fractures in children during the last decade in Northern Finland. Another objective was to study the background factors, treatment, and re-displacement of these fractures. Materials and methodsAll 168 children (<16 years) admitted to our paediatric trauma centre due to diaphyseal both-bone forearm fractures during 2000–2009 were included. The type of injury, background factors, radiographics, treatments and re-dislocations were reviewed. The age-related incidence rates were evaluated. ResultsThe incidence of diaphyseal both-bone forearm fractures increased 4.4-fold (95% CI 2.0–10.8; P<0.001) between 2000 (8.2/100000) and 2009 (35.9/100000). The increase in the incidence was accelerating (P<0.001) and the overall increase was 338%. The incidence of surgical treatment for diaphyseal fractures increased 4.2-fold (95% CI 1.9–10.4, P=0.001), which is in relation to increasing number of fractures. However, internal fixation increased from 13.3% in 2000–2001 to 52.7% in 2008–2009 (P=0.015), as an alternative to conservative treatment. The re-displacement rate was high (29.9%) amongst the patients with conservative treatment compared to those who were invasively operated (1.4%) (P<0.001). The mean age of the patients increased by 2.4 years in the study period (P=0.019). Trampoline was the most important and still increasing reason for the fractures. At the beginning of the study, there were no trampoline-related fracture, but towards the end of the study 30–41% of the fractures were caused by a trampoline injury (P=0.004). ConclusionsThere was an accelerating increase in the incidence of paediatric diaphyseal both-bone forearm fractures during the last decade. Trampoline was the most important and still increasing reason for these fractures. The mean age of the patients was increasing. Increasing proportion of diaphyseal both-bone forearm fractures was treated operatively. Re-displacement was unusual amongst operated cases.

Trampoline Trauma in Children

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. 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. 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%). 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.

143: A Prospective Evaluation of Risk Factors Affecting the Severity of Pediatric Trampoline Injuries

143: A Prospective Evaluation of Risk Factors Affecting the Severity of Pediatric Trampoline Injuries

Effectiveness of pads and enclosures as safety interventions on consumer trampolines

BackgroundTrampolines continue to be a major source of childhood injury.ObjectiveTo examine available data on trampoline injuries in order to determine the effectiveness of padding and enclosures.DesignTrampoline injuries from the NEISS...

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.