Tucson Orthopaedic Institute, P. C.


		Hidden Hazards of Childhood: Playgrounds Need Attention September 2003
		Many a proud parent will be shocked to hear that 177,395 childhood injuries treated at hospitals in 2002 were the results of accidents on playground climbing equipment. Injuries on swings totaled 137,681 and on slides there were 98,047. The American Academy of Orthopaedic Surgeons has launched the “Prevent Injuries America!”® campaign to promote playground safety guidelines to supervising adults, including recreation managers, daycare workers, babysitters, and school and city officials, as well as parents who may not be aware of the hazards. The list of playground hazards is long, but badly designed equipment and poor maintenance are key contributors to accidents. Parents may not realize that there are U.S. Consumer Product Safety guidelines for playground equipment. Equipment problems should be reported to officials. Parents also should take time to observe how their children are using playground equipment and be sure their activities are safe for their age. “It is important not to let tots into playground activities meant for older, larger and stronger children,” says Brian B. Nielsen, M.D., a specialist in pediatric orthopaedic surgery at Tucson Orthopaedic Institute. “Little kids lack the judgment to decide what is safe for them. It is very hard when they see older kids doing something that looks like lots of fun. They don’t want to be left out, but they have no idea of the dangers.” Small children often are left without close supervision on playgrounds near playing fields while parents are watching older siblings in organized sports. Parents should always check to see if there are hard or slippery ground surfaces, another big contributor. Nielsen estimates that Tucson Orthopaedic treats over 1000 children a year with new fractures, but he suspects there are many fractures that go undetected or are ignored. This is of real concern. “We worry most about growth plate fractures,” Nielsen explains. “The ends of bones have cartilage-like disks from which the bone grows. In playground accidents, these weak ends are vulnerable, and a break could result in crooked bone growth or no growth at all.” A growth plate fracture can only be detected by x-ray, one reason it is so important to get an injured child to a pediatric orthopaedic surgeon within a few days after an accident. What is thought to be an ankle sprain may actually be a growth plate fracture. Another reason is that the growth plate will heal faster than bone, so it needs treatment and follow-up within a few days to ensure the best chance of growing properly. Any time of year, children having a really good time on playgrounds are at high risk. Their imaginations are “running wild” and they are not thinking about real and present dangers. Cooler weather presents special risks. Drawstrings in sweatshirt hoods can easily get caught and even potentially strangle a child. Heavy rain and snow are		damaging to the equipment and leave slippery mud. Sunny days take their toll, too, as that’s when we can expect a heavy use of the playground. Crowding and colliding can leave bad bumps and bruises and worse. Prevent Safety America! Safety Tips Avoid playground that have concrete, asphalt, hard-packed dirt, or grass. Steer children to age-appropriate playground equipment. Check to see that there is enough space for kids to easily get off the slide or merry-go-round. Don't let kids crowd around the exit areas. Try the hand grips to verify they are shaped and sized for easy grip. Swing seats should be made of plastic or rubber: avoid metal or wood. Avoid any equipment that has openings which could entrap a child's head. Be sure you can clearly see your children on the playground. The kids should have clear, unobstructed views from their height. For more advice, see the Prevent Injuries America! website at www.aaos.org or call the public service telephone number of the American Academy of Orthopaedic Surgeons: 1-800-BONES (2663). Guidelines for playground equipment are available free of charge from U.S. Consumer Product Safety Commission, Washington, DC, 20207. Growth Plate Fractures A long bone does not grow from the center outward but at the ends around the growth plates. The growth plates regulate growth and determine the length and shape of a mature bone. They are the last portions of bone to harden. In a child, the ligaments may be stronger than bone. What is thought to be an ankle sprain may actually be a growth plate fracture. About 20 percent of growth plate fractures occur as a result of recreational activities, and about a third in competitive sports. Most growth plate fractures occur in the long bones of the fingers and the outer bones of the forearm (radius). Casts are commonly used to immobilize the bones during the healing period, but internal fixation comes into play when the growth plate is completely disrupted. Contact: Brian B. Nielsen, M.D. (520) 784-6200. Same Day Fracture Clinic Tucson Orthopaedic Institute sponsors a Same Day Fracture Clinic to see patients with newly broken bones within the same or the next day after the accident. Call the east office at 784-6200 or the northwest office call 382-8200. KGUN 9 News Story with Brian B. Nielsen, M.D. Requires Flash Player 8 to view.
		Pediatric Orthopaedics News

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