April 20, 2017

Preventing broken bones in kids during 'fracture season'

In some parts of the country, people say there are really only two seasons: winter and construction. Add a third — "fracture season," say experts in children's health at American Family Children's Hospital in Madison, Wis.

We're in the heart of fracture season right now. Warm spring temperatures and the end of school combine to send thousands of kids into backyards and onto playgrounds, where they're breaking their bones at startling rates-on inline skates, on bikes, playground equipment and trampolines.

"Of all the walk-in injuries seen in clinics from play equipment, fractures account for 25 to 30 percent of them," says Blaise Nemeth, MD, a pediatric orthopedics specialist at American Family Children's Hospital.

Each year, 200,000 children injure themselves on playgrounds in America and another 200,000 get hurt on trampolines. Most of these injuries occur in kids under age 15. On the playground, falling off monkey bars and slides are big culprits; arms are the most frequently fractured bones. But one dangerous situation is something parents often don't immediately recognize: sliding down the slide with their toddlers.

"Their initial thought is this is actually safer," explains Nemeth, who is also on the University of Wisconsin School of Medicine and Public Health faculty. "But what happens is that the child's foot catches on the slide and then twists backwards as the adult's weight pushes them both forward, breaking the child's shin bone."

Statistics on childhood accidents

  • Bikes and rollerblades also account for a huge number of fractures

  • Children sustain approximately 267,000 non-fatal bicycle injuries each year

  • Some 135 children are killed as bicyclists annually

  • Additionally, more than 176,000 children ages 5 to 14 are treated each year in hospital emergency rooms for injuries related to skateboards, scooters and skates

"For what we call 'wheeled safety' sports, wearing a helmet is critical to preventing head injuries-that's the single most effective safety device we have to reduce head injury and death from crashes," says Nan Peterson, director of the SAFEkids program at American Family Children's Hospital. "In addition to helmets, kids who inline skate should also wear knee, wrist guards and elbow pads, and skate on a smooth surface where there's no traffic."

When it comes to trampolines, UW pediatricians and safety experts are in strong agreement with American Academy of Pediatrics guidelines: the safest course of action is to not use them. Michael Kim, MD, a pediatric emergency doctor at American Family Children's Hospital and associate professor of emergency medicine/pediatrics at the UW School of Medicine and Public Health, says the list of trampoline injuries goes well beyond just fractures.

"We frequently see severe head injuries that need surgery and some resulting in brain damage. Along with head injuries, spinal cord injuries that result in paralysis can occur. Although fractures are common, other injuries such as cuts, bruises, sprains and strains occur frequently," Kim says these injuries occur when they land wrong or off the trampoline, try dangerous stunts or land on other kids.

Most injuries occur on the mat itself. Most trampoline injuries occur, says Nemeth, when multiple children are bouncing on the trampoline together.

"The large spring-back effect that creates makes it almost like landing on the ground," he notes. Being aware of situations like this can go a long way toward making fracture season a lot safer.

"Supervision is key," agrees Nemeth. "While even the closest supervision won't prevent every injury, it can play a major part in reducing the dangerous situations that lead to fractures.