All I want for Christmas is a closed reduction of my spiral radial fracture

Yes, just in time for the Christmas shopping season comes a study from the journal Clinical Pediatrics showing that pediatric toy-related injuries have jumped almost 40% since 1990. Notably, this study did not include the numerous parental injuries from tripping over and stepping on said toys.

The types of risks for injuries were obviously related to the age groups studied. For children under 3 years old, the main issues were ingestion or choking on small toys or parts of toys. This study revealed over 100,000 incidents of foreign body ingestions in children under 5 years old – that works out to 14 cases/day. (Which leads to an actual patient of mine and this x-ray – can you guess what game she was playing?)

For older children the injuries change as you add wheels. For 5-17 year olds, items such as scooters, wagons, and tricycles (I’m not sure why 5-17 year olds would be on a tricycle) caused 42% of their injuries, compared to just 28% in the younger than 5 year old set. In addition, these wheeled demons were also associated with a 3-fold risk of a fracture or dislocation.

One particular culprit especially singled out was foot-powered scooters, or as they are more commonly known, scooters. The authors of the study noted the popularity and use of these “scooters” was responsible for most of the increase seen over the course of their study.

Some other fun facts:

  • The most common age of injury was 2, and kids under 5 accounted for 50.5% of all injuries
  • 4 out of 5 injuries occurred at home and 63% involved boys. (As the father of two boys, I can tell you this surprises me not at all.)
  • Seasonal variation: 57% of total incidents occurred from April to September.
  • 98% of kids seen in the ED were NOT admitted, but 43% of those admitted were from ride-on toy injuries.

In their conclusion, the study authors called for ”improvements in toy safety standards, product design, recall effectiveness, and consumer education.”

While the authors’ concluding statement is likely true, it is not clear from this study that these injuries were caused by faulty or poorly-designed toys. Rather more likely these kids were injured using the toys as they were intended (with a few exceptions I’m sure – see having boys above).

As a practicing pediatrician in an era of increasing childhood obesity, I find these results frustrating. We always try to find any opportunity to encourage physical activity in children but balanced with the risk of the activity. (See AAP policy on trampolines.) Hopefully this study can emphasize the importance of safety measures without scaring off parents.

Jeff Ribordy, MD

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