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Young Children Four Times More Likely to Sustain Head Injury from Sledding


Very young children are four times more likely than older children to sustain a head injury while sledding according to a new study reported in the September issue of Pediatrics.

Candace A. Howell, MD, of Nationwide Children's Hospital in Columbus, Ohio, and colleagues analyzed data on emergency department visits from the National Electronic Injury Surveillance System. Diagnosis codes were used to select sledding-related injuries.

An estimated 229,023 patients under the age of 19 years of age were treated between 1997 through 2007 for sledding-related injuries in US emergency departments, with an average of 20 820 cases per year.

Types of injuries included fractures, contusions and abrasions, sprains and strains, and traumatic brain injuries.

Taking all injuries together, children 10 to 14 years of age (42.5%) and boys (59.8%) had the most injuries.

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Fractures were the most frequent injury (26.3%) and occurred most often in children 10 to 14 years of age.

The second most frequent injury was found to be contusions and abrasions (25.0%).

The most commonly injured body part was the head (34.1%). Children 4 years of age and younger were four times more likely than older children to sustain a head injury. Head injuries were twice as likely to occur during collisions, reported in 50.6% of the cases.

The collisions occurred between sled and stationary objects (trees, light poles) in more than half the cases. Alarming was the finding that almost one-fifth involved a moving vehicle, and the majority of these cases resulted in head injuries.

Head injuries were more common with snow tubes than with other sled types. Snow tubes are very fast and cannot be controlled.

Howell and her colleagues offer some safety tips for sledding:

  1. Sledding areas should be free of trees and other obstacles, and should be far from streets and highways.
  2. The use of sleds that can rotate, such as snow disks and tubes, should be discouraged.
  3. Young children need to be supervised while sledding.
  4. The use of helmets -- already recommended by the Consumer Product Safety Commission for children while skiing and snowboarding -- should be considered.

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Howell C, et al "Pediatric and adolescent sledding-related injuries treated in US emergency departments in 1997-2007" Pediatrics 2010; 126: 517-524.