Pediatric Fractures Secondary to Trampoline Injury: A Prospective Analysis of User Circumstances and Injury Severity with Respect to AAP Policy Statement

INTRODUCTION: The purpose of this study was to prospectively analyze injury patterns and severity with respect to AAP/CSMF safety guidelines, and to report parental safety-awareness and behavior.
METHODS: 299 consecutive patients were enrolled. Measures of severity included the Abbreviated Injury Scale (AIS), and need for sedated procedure/ surgery. Risk factors were defined by the AAP/CSMF recommendations.
RESULTS: Of the 299 patients, 99% (296/299) had severe/serious or moderate AIS scores. 49% (147/299) required a surgical intervention or sedated fracture manipulation. An adult was present during 72% (214/299) of injuries, and 55% (164/299) of injuries occurred with use of protective safety devices. 86% (255/299) of injuries occurred with multiple children on the trampoline. 42% (126/299) of injuries occurred in children less than 6 years of age, and a high risk maneuver was attempted in 23% (70/299). Children less than 6 years old did not sustain more severe injuries compared to older children (p=0.81). Paradoxically, having less children on the trampoline correlated to sustaining more severe injuries (p = 0.03). 83% (248/299) parents reported awareness of the dangers of trampolines prior to their child’s injury.
DISCUSSION AND CONCLUSION: This study reinforces the AAP/CMSF discouragement of home trampoline use, multiple jumpers, and younger children. Safety equipment, avoidance of high risk maneuvers, parental supervision, and parental awareness trampoline dangers did not decrease injury severity. There is no such thing as 'safe' trampolining, and severe injuries occur despite the best vigilance of parents.