Playground equipment-related extremity fractures in children presenting to US emergency departments, 2006–2016

Abstract

Background Despite 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. Methods We 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. Results An 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. Conclusions Despite 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.

Paediatric playground and tree‐related injuries: Hospital admissions in the Midland region of New Zealand

“…In line with other studies, 1,3–7 upper extremity injuries were the most common (69.9%) of all injury diagnoses related to playground and tree‐related incidents. Forearm and upper arm fractures accounted for 90.3% of these injuries.…”

“…Playgrounds offer physical, cognitive and social benefits for children that include opportunities to develop imagination and evaluate risk 1 . However, children are prone to falls and hospitalisations due to playground injuries are common 2–5 . In New Zealand, there is little current information related to playground injuries.…”

“…1 However, children are prone to falls and hospitalisations due to playground injuries are common. [2][3][4][5] In New Zealand, there is little current information related to playground injuries. Studies in the 1990s reported hospitalisation rates of 137/100 000 for playground injuries in 0-14-year olds 6 and 26.5-30.3/100 000 for trampoline injuries in 5-14-year olds.…”

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

“…Multiple studies have shown that children sustain a high number of injuries when playing on the playground, with one study reporting that 64.2% of ED presentations after falls from the monkey bars were due to fractures. 2 , 5 , 12 , 13 SCHFx are the most common type of fracture associated with falls from the monkey bars, accounting for nearly 40% of long-bone fractures, and 75% of these SCHFx require hospital admission for surgical intervention. 5 , 14 Over the years, there has been a decline in injuries from using the slide or swings on playgrounds, but the prevalence of injuries associated with the use of the monkey bars has remained unchanged.…”

“…Many of these fractures are commonly related to playground equipment, with an annual incidence rate of 119.2 injuries per 100,000 children. 2 More than 50% of pediatric extremity fractures requiring hospitalization are due to play on monkey bars and climbing gyms. A large proportion of pediatric supracondylar humerus fractures are also from playground equipment.…”