Development of a multidisciplinary method to determine risk factors for arm fracture in falls from playground equipment

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Abstract
Objectives: To present the development of a novel multidisciplinary method to investigate physical risk factors for playground related arm fracture. Rationale: Previous playground injury research has been limited in its ability to determine risk factors for arm fractures, despite their common and costly occurrence. Biomechanical studies have focused exclusively on head injury. Few epidemiological studies have quantified surface impact attenuation and none have investigated specific injury outcomes such as arm fracture. Design: An unmatched case-control study design was developed. An instrumented child dummy and rig were designed to simulate real playground falls in situ. Validated output from the dummy was used to quantify arm load. Other field measurements included equipment height, fall height, surface depth, headform deceleration, and head injury criterion. Discussion: Validated methods of biomechanics and epidemiology were combined in a robust design. The principle strength of this method was the use of a multidisciplinary approach to identify and quantify risk and protective factors for arm fracture in falls from playground equipment. Application of this method will enable countermeasures for prevention of playground related arm fracture to be developed.