Pediatric Falls: Are Monkey Bars Bad News?

Background Falls are a leading cause of childhood trauma and are the most common mechanism of injury seen in the emergency department (ED). Playground injuries represent a significant fraction of these falls. Objectives This study aims to compare the frequencies of fractures from monkey bars to other types of falls and to explore the statistical associations between the types of injuries. Methods We conducted a cross-sectional study through a retrospective chart review of all British Columbia Children's Hospital ED visits between March 2011 and February 2012. We manually extracted data from ED visits for falls in children two to 17 years of age and used descriptive statistics to report the frequencies of injuries and outcomes. We conducted multivariate logistic regression analyses to compare the odds of fractures associated with various types of falls. Results We reviewed 43,579 ED visits, of which 3,184 (7.3%) were falls. The most common types were from a standing height (42.5%), falls at home (16.2%), and at the playground (14.3%). Peaking in school-age children, these falls resulted in a diagnosis of fracture (37.3%), soft tissue contusion (20.1%), laceration/abrasion (19.4%), and minor head injury (15.8%). We identified 151 falls from monkey bars, among which 64.2% resulted in a fracture. The odds of a fracture following a fall from monkey bars was 3.1 times that of falls from all other causes. Conclusions ED physicians should have a higher suspicion for a diagnosis of fracture if a child reportedly fell from monkey bars. It is warranted to educate parents and educators on the risks associated with the play on these climbing structures.