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Getting a jump on childhood injuries (08/07/2005)
"It only takes a split second for a child to be seriously injured, but the effects of serious brain, spinal-cord or bone injuries can last a lifetime," says Steven Koop, M.D., a pediatric orthopaedic surgeon at Gillette Children's Specialty Healthcare in St. Paul, Minn.

Koop, Stephen Sundberg, M.D., and Kevin Walker, M. D., -- also pediatric orthopaedic surgeons at Gillette -- regularly treat children with injuries to their arms, legs, heads and spinal cords. Asked what dangerous activities they'd like to see children avoid, all three doctors replied, "Trampolines."

Notes Sundberg, "While the majority of trampoline injuries tend to be temporary inconveniences that destroy a child's summer, all too often, they're much more serious." He adds, "One weekend when I was on call, I saw three children with injuries from trampolines that were severe enough to require surgery."

According to the U.S. Consumer Product Safety Commission (CPSC), backyard trampolines sent more than 211,000 kids to hospitals, doctors' offices and clinics in 2003. Children ages 5 to 9 sustain about 20,000 of these injuries. That means the majority of injured children are older, heavier kids who -- often as not -- jump without supervision. That's not good news. By virtue of their size, when older kids fall they sustain more severe injuries to their limbs, necks and heads than younger children do. In addition, because of their size, older kids who jump with others risk serious injury if they collide with their friends.

Angela Dias, for example, grew up on backyard trampolines. The 9-year-old attempted a back flip and failed to complete a rotation. She landed on the top of her head and sustained a compression fracture of her spine. Doctors noted that had she been older or weighed more, her injuries might have been worse. Angela agrees. "I might have been paralyzed," she says. As it is, after 20 weeks she's still wearing a body jacket 24 hours a day.

Says Angela's mother, Louise Dias, "We locked up the trampoline until we could get it out of our yard."

The alarming number of trampoline injuries prompted the American Academy of Pediatrics (AAP) to call for a ban on home trampolines. It also urged families that had trampolines to get rid of them. For families who do have trampolines, Gillette doctors strongly advise allowing only one person at a time on the trampoline and providing adult supervision and instruction when someone is jumping. In addition, they recommend the American Association of Orthopaedic Surgeons (AAOS) guidelines listed below.

Given the number of injuries, it's easy to see why physicians also caution about the dangers of monkey bars, skateboards, inline skates and bicycles.

AAOS reports that monkey bars and other climbing equipment cause more than 175,000 injuries nationwide every year. Typically, climbing equipment is designed for children age 6 and older. Younger children might have difficulty with bars that are spaced too far apart or that are too big for their small hands. They also might lack the strength needed to use such equipment. AAOS advises supervising children closely and letting them play only on age-appropriate equipment.

As for bicycles, they're second only to automobiles when it comes to causing childhood injuries. In 2002, more than 285,000 children in the U.S. were treated in hospital emergency rooms for bike-related injuries. About half of these children sustained traumatic brain injuries.

About two-thirds of the 20 million in-line skaters who take to the streets in the U. S. each year wear no safety gear; 11,000 of them suffer head or facial injuries.

Skateboarding causes 50,000 injuries annually in the U.S. In addition, about 1,500 children and teens sustain skateboard injuries that require them to be hospitalized, most with catastrophic brain injuries.

The collapsible frames, lightness and speed that make scooters so attractive to kids also make them dangerous. During the first nine months of 2001, the Consumer Product Safety Commission (CPSC) documented 16 scooter-related deaths. It also reported 84,400 injuries to children 12 and under. Most of the accidents involved motor vehicles. Traumas to the head and face account for 27 percent of all such injuries.

Oddly enough, scooters are best suited to smooth asphalt surfaces of roadways -- where children shouldn't be playing. But injuries also occur in driveways and on sidewalks, leading CPS to conclude it's difficult to recommend a safe place for children to ride them, even when kids wear helmets.

In spite of their best efforts, parents can't eliminate risks. "Kids are still going to ride too fast and jump too high. Some injuries are unavoidable," says Sundberg. "But there are steps families can take to help reduce the risk of serious injury."

Trampoline Safety

AAOS advises the following:

Keep children 6 and under off full-size trampolines.

Use spotters when someone is jumping.

Place the trampoline jumping surface at ground level. Cover springs, hooks and frames, supporting bars, and surrounding landing surfaces with protective padding.

Never use trampolines for unsupervised recreational activity. Lock up trampolines when they're not in use.

Avoid doing somersaults or high-risk maneuvers without proper supervision and instruction. Perform these moves only while using proper protective equipment, such as a harness.

If the Helmet Fits, Wear It!

Most bike, skateboard and in-line skaters are injured because they use inadequate protection. Helmets can significantly reduce head and brain injuries. That's why the AAOS recommends the following precautions:

Wear a properly fitting, multi-use helmet no matter what the rider's age or level of experience or expertise.



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