Trampoline was used by British & American fighter pilots as a training device during World War II. It became popular among Civilian as a recreational sports during 50s and 60s. Trampoline related injuries including quadriplegia and death have been reported from United States and Europe. We are reporting the incidence, type and distribution of trampoline-related injuries in children in a District General Hospital in United Kingdom.

Recently we treated three serious injuries – proximal tibial fracture associated with popliteal artery injury, subtrochanteric fracture of femur and cervical fracture-dislocation leading to quadriplegia, that lead to an audit study. This is a retrospective analysis of trampoline-related injuries in children seen in the Accident & Emergency Department over three months period. The casualty cards and admission records were reviewed.

The mechanism of injury was fall on or off the trampoline in 98.15%(53/54). All injuries occurred on back-garden or leisure-centre trampoline. 74% of injuries were sustained while unsupervised.

The incidence of soft tissue injuries were 59.25%(32/54) and fractures 40.75%(22/54). Soft tissue injuries commonly involved lower limb(16), upper limb(7) and head and neck(4). Fractures commonly involved upper limb(13), lower limb(8) and nasal bone(1). The fractures involved wrist and forearm in eight cases, ankle in five, elbow in four and one case each involving finger, hip, knee and toe. The treatment of trampoline-related injuries varied from reassurance, analgesia, tubigrip bandage to plaster cast. Fourteen(26%) patients were admitted into the wards and ten(18.5%) required surgical treatment.

The incidence of trampoline-related injuries in back-garden and leisure-centre when unsupervised was high. The supervision by an adult has not proved to be very effective in preventing the injuries as 26% of trampoline-related injuries occurred under supervision of an adult.

The morbidity related to leisure trampolining is high probably due to lack of training and non-compliance to the manufacturer instructions in the use of trampoline. We would recommend banning the routine use of back garden trampoline without proper training and supervision.

The use of antenatal abdominal ultrasound (AAU) in the diagnosis of clubfoot is established. The accuracy of the investigation is unclear, leaving difficulties for the clinician involved in counselling parents.

This study was conducted to investigate the accuracy of AAU in the diagnosis of clubfoot. We assessed the AAU findings of mothers of 20 children with varying degrees of clubfoot deformity between 1993 to 1998. There were 12 males and 8 females; 30 feet were affected - 6 were left, 8 right sided and 8 were bilateral. There were two sets of twins, each with bilateral deformity. The mean foetal age at diagnosis was 23.4 weeks ( range 18–35 weeks).

Three patients had oligohydramnios and two had polyhydramnios. One patient had an amniocentesis that was normal. Karyotyping was not performed. There were no false positive or false negative results.

Our results show 100% concurrence between the scan results and the clinical findings at birth. Three clubfeet were reported as being positional; their clinical diagnoses revealed a mild deformity that needed no treatment other than reassurance and advice. Twenty one feet were treated with physical therapy, manipulation and serial castings. Six feet required surgery.

AAU in the second trimester of pregnancy is a reliable method of diagnosing clubfoot, and the parents can be counselled with confidence regarding management. As AAU is currently offered to almost all pregnant women, it can be expected that more cases of clubfeet will be diagnosed in the antenatal period. An orthopaedic surgeon must be prepared to counsel parents even before a clinical examination is possible.