Use of wheeled recreational device in kids may result in severe injuries

Children who use wheeled recreational devices (WRDs) are prone to severe injuries, such as fractures and dislocations, according to a Singapore study. Factors related to a higher risk of such injuries include school-going age, increased weight, injury location, and scooter, skateboard, and inline skate use.

“The use of wrist and elbow guards, as well as helmets, should be recommended, along with adequate parental supervision,” the researchers said.

This 5-year study assessed injuries associated with WRD use in children aged <18 years who presented to the emergency department of an Asian tertiary hospital between 2016 and 2020. The researchers analysed demographic data, site and nature of injury, and historical trends. They also evaluated the risk factors for severe injury, Injury Severity Score ≥9, and injuries resulting in hospitalization.

A total of 5,002 patients (median age 4.7 years) with 5,507 WRD-related injuries were taken care of during the study period. The most frequent injuries were related to bicycles (54.6 percent) and scooters (30.3 percent), followed by skateboards and waveboards (7.4 percent), inline skates (4.7 percent), and tricycles (3.0 percent). [Ann Acad Med Singap 2022;51:531-539]

Injuries usually occurred in public spaces. The most frequent diagnoses were soft tissue injuries (49.3 percent) and fractures (18.7 percent), while the most common sites were the upper limb (36.4 percent) and head and neck (29.0 percent).

Nearly a third of these patients (n=1,910, 38 percent) suffered severe injuries with potential morbidity. Multivariate analysis revealed that heavier children of school-going age who use wither scooters, skateboards, or inline skates were at higher risk of severe injuries. In addition, involvement in a vehicular collision was a negative predictor.

An earlier study also found an increased risk of fractures among those ≥8 years of age, although younger children were more predisposed to head and facial injuries. [Pediatr Emerg Care 2004;20:588-592]

On the other hand, older children who are faster, stronger, and larger in size tended to go at greater speeds, which could result in more serious injuries. Likewise, teenagers were more inclined to participate in risk-taking behaviour and competitive situations. [Dev Rev 2008;28:78-106]

“Education on primary prevention strategies is likely to have higher impact when targeted at school-going age children and their parents,” the researchers said. “In line with encouraging active play and a shift towards active mobility, schools should play a bigger role in educating parents and children on the risk of such device-related injuries and preventative measures.”

National Cycling Plan

Public policy and attitudes in Singapore have shifted towards the promotion of active mobility over the years. The National Cycling Plan was then established as a collaborative governmental effort to make cycling a safe, healthy, and convenient transport option for Singaporeans. This plan included building a comprehensive islandwide cycling network, spanning >1,300 km by 2030.

“The Active Mobility Act was passed in Singapore in 2017 to regulate the safe use of personal mobility devices, including allowing the use of selective mobility devices such as bicycles, skateboards, and electric scooters on public paths subject to a set of rules and codes of conduct,” the researchers said. [Singapore Law Review Juris Illuminae 2016/17;8]

“Apart from regulatory measures to enable safer road-sharing, education on the safe use of such devices from a young age will also be key. This can include the need for age-appropriate use of various devices, adequate supervision, and proper use of protective gear,” they added.