Out on a limb: risk factors for arm fracture in playground equipment falls.

نویسندگان

  • S Sherker
  • J Ozanne-Smith
  • G Rechnitzer
  • R Grzebieta
چکیده

OBJECTIVES To investigate and quantify fall height, surface depth, and surface impact attenuation as risk factors for arm fracture in children who fall from playground equipment. DESIGN Unmatched case control study. SETTING Five case hospitals and 78 randomly selected control schools. PARTICIPANTS Children aged less than 13 years in Victoria, Australia who fell from school playground equipment and landed on their arm. Cases sustained an upper limb fracture and controls had minor or no injury. A total of 402 cases and 283 controls were included. INTERVENTIONS Children were interviewed in the playground as soon as possible after their fall. MAIN OUTCOME MEASURES Falls were recreated on site using two validated impact test devices: a headform (measuring peak G and HIC) and a novel anthropometric arm load dummy. Equipment and fall heights, as well as surface depth and substrate were measured. RESULTS Arm fracture risk was greatest for critical equipment heights above 1.5 m (OR 2.39, 95% CI 1.49 to 3.84, p<0.01), and critical fall heights above 1.0 m (OR 2.96, 95% CI 1.71 to 5.15, p<0.01). Peak headform deceleration below 100G was protective (OR 0.67, 95% CI 0.45 to 0.99, p = 0.04). Compliance with 20 cm surface depth recommendation was poor for both cases and controls. CONCLUSIONS Arm fracture-specific criteria should be considered for future standards. These include surface and height conditions where critical headform deceleration is less than 100G. Consideration should also be given to reducing maximum equipment height to 1.5 m. Improved surface depth compliance and, in particular, guidelines for surface maintenance are required.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

METHODOLOGIC ISSUES Out on a limb: risk factors for arm fracture in playground equipment falls

Objectives: To investigate and quantify fall height, surface depth, and surface impact attenuation as risk factors for arm fracture in children who fall from playground equipment. Design: Unmatched case control study. Setting: Five case hospitals and 78 randomly selected control schools. Participants: Children aged less than 13 years in Victoria, Australia who fell from school playground equipm...

متن کامل

Development of a multidisciplinary method to determine risk factors for arm fracture in falls from playground equipment.

OBJECTIVES To present the development of a novel multidisciplinary method to investigate physical risk factors for playground related arm fracture. RATIONALE Previous playground injury research has been limited in its ability to determine risk factors for arm fractures, despite their common and costly occurrence. Biomechanical studies have focused exclusively on head injury. Few epidemiologic...

متن کامل

School Playground Surfacing and Arm Fractures in Children: A Cluster Randomized Trial Comparing Sand to Wood Chip Surfaces

BACKGROUND The risk of playground injuries, especially fractures, is prevalent in children, and can result in emergency room treatment and hospital admissions. Fall height and surface area are major determinants of playground fall injury risk. The primary objective was to determine if there was a difference in playground upper extremity fracture rates in school playgrounds with wood fibre surfa...

متن کامل

Analysis of energy flow during playground surface impacts.

The amount of energy dissipated away from or returned to a child falling onto a surface will influence fracture risk but is not considered in current standards for playground impact-attenuating surfaces. A two-mass rheological computer simulation was used to model energy flow within the wrist and surface during hand impact with playground surfaces, and the potential of this approach to provide ...

متن کامل

Are current playground safety standards adequate for preventing arm fractures?

OBJECTIVE To assess compliance with current standards of playgrounds where children have sustained a fall-related arm fracture. DESIGN, SETTING AND PARTICIPANTS Between October 2000 and December 2002, a consecutive prospective series of 402 children aged under 13 years who fell from playground equipment and sustained an arm fracture was identified by emergency department staff in five Victori...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention

دوره 11 2  شماره 

صفحات  -

تاریخ انتشار 2005