Open Access

Skateboards: Are they really perilous? A retrospective study from a district hospital

BMC Research Notes20081:59

DOI: 10.1186/1756-0500-1-59

Received: 22 February 2008

Accepted: 31 July 2008

Published: 31 July 2008

Abstract

Background

Skateboarding has been a popular sport among teenagers even with its attendant associated risks. The literature is packed with articles regarding the perils of skateboards. Is the skateboard as dangerous as has been portrayed?

Methods

This was a retrospective study conducted over a 5 year period. All skateboard related injuries seen in the Orthopaedic unit were identified and data collated on patient demographics, mechanism & location of injury, annual incidence, type of injury, treatment needed including hospitalisation.

Results

We encountered 50 patients with skateboard related injuries. Most patients were males and under the age of 15. The annual incidence has remained low at about 10. The upper limb was predominantly involved with most injuries being fractures. Most injuries occurred during summer. The commonest treatment modality was plaster immobilisation. The distal radius was the commonest bone to be fractured. There were no head & neck injuries, open fractures or injuries requiring surgical intervention.

Conclusion

Despite its negative image among the medical fraternity, the skateboard does not appear to be a dangerous sport with a low incidence and injuries encountered being not severe. Skateboarding should be restricted to supervised skateboard parks and skateboarders should wear protective gear. These measures would reduce the number of skateboarders injured in motor vehicle collisions, reduce the personal injuries among skateboarders, and reduce the number of pedestrians injured in collisions with skateboarders.

Findings

Skateboarding is a popular recreational activity among youngsters. The capability of attaining speeds up to 40mph and the possibility of performing various tricks have added a thrill factor to this sport [1]. Its inherent instability adds to the excitement of skateboarding. There is little wonder that a wide range of injuries are seen with skateboarding.

With reported deaths and an ever increasing morbidity, there have been calls to "ban the boards" [2]. Most studies highlight the dangers of skateboarding [35]. There are other studies that suggest that most skateboard injuries are minor [6, 7].

Is the skateboard really dangerous? Is the call to ban skateboards justifiable? We aimed to answer these questions in our study.

Methods

This was a retrospective analysis of skateboard injuries encountered by the Orthopaedic unit in a busy district hospital that caters to a population of about 100000, 28% being children. Being a popular holiday haven, the population triples during the summer. The Orthopaedic unit receives about 2200 trauma admissions, performs 1700 trauma procedures and assesses 5000 new patients in the fracture clinics annually.

Over a five year period (2002 – 2006) we included all skateboard related injuries seen by the Orthopaedic unit. Data was obtained from patient records and radiographs. The following data was collected:
  1. 1.

    Patient demographics

     
  2. 2.

    Annual incidence of skateboard related injuries

     
  3. 3.

    Mechanism of injury

     
  4. 4.

    Location where injury occurred

     
  5. 5.

    Seasonal variation

     
  6. 6.

    Injuries seen

     
  7. 7.

    Hospitalisations following skateboard related injuries

     
  8. 8.

    Surgical interventions

     
  9. 9.

    Treatment

     
  10. 10.

    Deaths

     

Results

We encountered 50 patients with skateboard related injuries during the study period. (Table 1) of whom 40 were males and 39/50 were <15 years of age. The mean age was 15.3 years (Range 6 – 50). Patients were divided into 5 age groups: 0–5, 6–10, 11–15, 16–19, >20 years. (Figure 1)
https://static-content.springer.com/image/art%3A10.1186%2F1756-0500-1-59/MediaObjects/13104_2008_Article_59_Fig1_HTML.jpg
Figure 1

Age incidence of skateboard injuries.

Table 1

Patient profile, annual incidence, injuries & treatment

Patient ID

Age

Sex

Year

Diagnosis

Treatment

Hospitalisation

1

15

M

2002

Fracture distal radius

Plaster

No

2

13

F

2002

Soft tissue injury wrist

Splint

No

3

11

M

2002

Fracture proximal phalanx middle finger

Neighbour strapping

No

4

11

M

2002

Fracture medial cuneiform

Plaster

Yes

5

13

M

2002

Fracture distal tibia

Plaster

Yes

6

16

M

2002

Fracture 4th metacarpal

Plaster

No

7

12

M

2003

Fracture proximal phalanx thumb

Thumb spica plaster

No

8

11

M

2003

Fracture clavicle

Sling

No

9

12

M

2003

Fracture femur

Traction

Yes

10

15

M

2003

Fracture index finger middle phalanx

Neighbour strapping

No

11

16

M

2003

Fracture ring finger proximal phalanx

Neighbour strapping

No

12

11

M

2003

Fracture calcaneum

Plaster

No

13

40

M

2003

Fracture radial head

Sling

No

14

12

M

2003

Fracture proximal phalanx thumb

Thumb spica plaster

No

15

18

M

2003

Fracture greater tuberosity humerus

Sling

No

16

10

F

2003

Soft tissue injury wrist

Plaster

No

17

12

M

2003

Fracture third metacarpal neck

Plaster

No

18

15

M

2003

Fracture second metacarpal neck

Plaster

No

19

11

M

2004

Soft tissue injury wrist

Plaster

No

20

17

M

2004

Ankle sprain

Tubigrip

No

21

16

M

2004

Fracture distal radius

Plaster

Yes

22

11

F

2004

Soft tissue injury shoulder

Sling

No

23

18

M

2004

Fracture ulnar styloid

Plaster

No

24

16

M

2004

Fracture radial head

Sling

No

25

6

F

2004

Fracture distal radius

Plaster

No

26

11

M

2004

Soft tissue injury knee

Tubigrip

No

27

14

M

2004

Soft tissue injury wrist

Plaster

No

28

14

M

2005

Fracture lateral malleolus

Plaster

No

29

13

F

2005

Fracture lateral malleolus

Plaster

No

30

13

F

2005

Fracture lateral malleolus

Plaster

No

31

12

M

2005

Fracture distal radius

Plaster

No

32

11

M

2005

Fracture ring finger proximal phalanx

Neighbour strapping

No

33

15

M

2005

Soft tissue injury wrist

Splint

No

34

50

M

2005

Fracture distal radius

Plaster

No

35

50

M

2005

Fracture radial head

Plaster

No

36

12

M

2005

Fracture distal radius and ulna

Plaster

Yes

37

11

F

2006

Fracture distal radius

Plaster

No

38

10

M

2006

Lateral collateral ligament injury knee

Splint

No

39

14

F

2006

Bimalleolar fracture ankle

Plaster

No

40

14

F

2006

Bimalleolar fracture ankle

Plaster

Yes

41

10

M

2006

Soft tissue injury knee

Splint

No

42

6

F

2006

Fracture clavicle

Sling

No

43

13

M

2006

Fracture distal radius

Plaster

No

44

14

M

2006

Dislocation DIPJ little finger

Neighbour strapping

No

45

33

M

2006

Fracture radial head

Sling

No

46

14

M

2006

Fracture fifth metacarpal neck

Plaster

No

47

11

M

2006

Fracture distal radius

Plaster

No

48

14

M

2006

Fracture distal radius

Plaster

Yes

49

13

M

2006

Fracture 2–5 metacarpal necks

Plaster

No

50

15

M

2006

Soft tissue injury wrist

Splint

No

Annual incidence and seasonal trend

The annual incidence did not vary to a large extent. (Figure 2) The mean incidence was 10 patients per year (Range 6 – 14). Most injuries were sustained during the summer (36/50).
https://static-content.springer.com/image/art%3A10.1186%2F1756-0500-1-59/MediaObjects/13104_2008_Article_59_Fig2_HTML.jpg
Figure 2

Annual incidence of skateboard related injuries encountered.

Mechanism and location of injuries

Most injuries (28/50) occurred while performing a trick on the skateboard, 1 patient was involved in a motor vehicle collision. The remaining patients lost balance and fell while on the skateboard. (Table 2)
Table 2

Mechanism of injury & location where injury sustained

Injury mechanism

Vehicle Collision

1

During trick

28

Lost balance

21

Location

Road

1

Skateboard park

21

Pavement

28

In 28/50 patients, the injury event occurred on the pavement. The rest of the injuries were sustained in a skateboard park or on the road. (Table 2)

Type of injury

Most injuries affected the upper limbs (37/50) with 39/50 being fractures.

Among the upper limb injuries seen, 30/50 were fractures while the rest were soft tissue injuries. Fractures were common in the hand (12/37), while the commonest upper limb region affected was the wrist (16/37). The distal radius was the most common upper limb fracture. (10/30) (Table 3)
Table 3

Upper limb injuries encountered

Fracture phalanges

6

Fracture metacarpals

5

Fracture radius & ulna

1

Fracture distal radius

9

Fracture ulnar styloid

1

Fracture radial head

4

Fracture clavicle

2

Fracture proximal humerus

1

Dislocation DIPJ little finger

1

Soft tissue injury wrist

6

Soft tissue injury shoulder

1

In the lower limb, 9/13 injuries were fractures. The ankle was the most injured region (7/13), with fractures around the ankle being the most common lower limb fracture (5/13). (Table 4)
Table 4

Lower limb injuries encountered

Fracture lateral malleolus

3

Bimalleolar fracture ankle

2

Fracture calcaneum

1

Fracture medial cuneiform

1

Fracture distal tibia

1

Fracture femur

1

Ankle sprain

1

Lateral collateral ligament sprain knee

1

Soft tissue injury knee

2

The most serious injury encountered was a femoral fracture that required traction.

Treatment

The most common treatment modality was immobilisation in plaster (32/50). (Figure 3) Manipulation and reduction of fractures/dislocations were needed in 2/50 patients. None of the injuries required surgical intervention and only 7/50 patients required hospitalisation for observation.
https://static-content.springer.com/image/art%3A10.1186%2F1756-0500-1-59/MediaObjects/13104_2008_Article_59_Fig3_HTML.jpg
Figure 3

Treatment modalities for skateboard injuries encountered.

Discussion

Skateboarding as a recreational sport has been around since the 1960s. Since its introduction design changes and improvement in the manufacturing materials, especially the poly-urethane wheels, has made the skateboard more manoeuvrable. The skateboard can reach up to speeds of 40 mph and a variety of tricks can be performed on them [1]. There has therefore been a rise in its popularity amongst youngsters.

Papers on skateboard injuries have been published since the 1960s [7]. With the rising incidence of injuries, the skateboard was even referred to as a "medical menace" [4]. The calls to ban the skateboard resulted in banning this popular sport from public roads and sidewalks in Sweden. In Norway, there was a complete ban on skateboarding in the 1980s [4].

Some articles use terms like "hazard" & "perilous" when describing the skateboard. Most articles highlight the various injuries sustained while skateboarding [3, 4, 79]. The skateboard has been portrayed as a villain causing increasing morbidity among youngsters.

Our department caters to a population of about 100,000, 28% being children. Skateboarding is a popular activity amongst youngsters in this region. There are a few skateboard parks in our locality. This study was initiated as the skateboard injuries seen by us were not severe and the numbers were insignificant. Our question was whether the skateboard deserved all the negative publicity among the medical community, it being popular among youngsters.

The incidence of skateboard injuries reported in the literature is varied [10, 11]. Zalvaras et al found only 187 skateboard injuries among 2371 fractures seen in a level1 trauma centre paediatric fracture clinic [12]. In a study by Schalamon J et al, the 4-month calculated incidence in children less than 16 years of age was 0.68 per 1,000 for skateboard injuries [7]. They suggested that skateboard injuries accounted for 2.6% of all paediatric traumas within a region. Our annual incidence was 10 patients per year among 5000 new fracture clinic attendances (2 per 1000). Compared to other recreational activities like scooter riding, roller skating and in-line skating, the incidence of skateboard related injuries is varied [7, 11, 12]. The injury characteristics seem to be similar among these activities with forearm injuries being more common [11]. The reported severity of injuries related to skateboards compared to the other activities has been varied in the literature [2, 11].

Head and neck injuries following skateboard accidents are commonly seen in children younger than 5 years [7]. The incidence of head injuries and critical injuries due to skateboarding accidents has been reported to be high [3]. We did not encounter any open fractures or head and neck injuries relating to skateboard injuries. Most skateboarding injuries reported in the literature are minor although the occurrence of potentially life threatening injuries has been documented [4].

In our study although most injuries were fractures, these were not severe and were managed conservatively. The most severe injury was a femoral fracture that was managed successfully in traction. Few patients (4%) required a manipulation for their fractures and only 14% needed to be hospitalised. This correlates with other studies in the literature. Illingworth et al encountered 40.9% fractures in 225 skateboard injuries of which only 19 patients required a manipulation under anaesthesia [8]. Our study did show that most injuries occurred on the pavement. To enhance safety while skateboarding, we agree with other studies with regards to encouraging youngsters to use supervised skateboard parks and use of protective gear [7, 10].

Our study has its limitations in that only patients encountered by the Orthopaedic unit were included. Patients with minor injuries like contusions & sprains may have been discharged from the Accident & Emergency. This would still show that most injuries with skateboard accidents are minor. We did not look at the effect of use of protective gear on skateboard injuries which is a limitation of the study. Based on the results of our study, the skateboard is not a dangerous sport and calls to ban this popular sport is not justified.

Conclusion

Our study found that skateboarding injuries, although present, were infrequent and not severe to call for banning of the sport. Use of protective gear and skateboard parks may lower the risk of injuries.

Declarations

Authors’ Affiliations

(1)
Department of Orthopaedics, Glan Clwyd Hospital
(2)
Department of Accident & Emergency, Glan Clwyd Hospital
(3)
Department of Orthopaedics, Glan Clwyd Hospital

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Copyright

© Rethnam et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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