Monkey Bar Dimensions Associated with Pediatric Upper Extremity Fractures Show Deviations from United States Product Safety Commission Recommendations.

Background Monkey bar injuries account for the majority of playground injuries, and 34% result in a fracture. Studies have shown that there has been no decline in the number of monkey bar injuries over several decades. Our goal was to focus on fractures of the upper extremity resulting from monkey bar injuries. Additionally, we set out to analyze the dimensions of the monkey bar apparatus on which the injury occurred and determine if they were compliant with those recommended by the United States (US) Product Safety Commission. Methods A retrospective chart review of all upper extremity injuries seen in a large pediatric orthopedic practice in 2017 was conducted to find all monkey bar-related injuries. Data was collected including age at the time of injury, gender, and injury type. Families of the injured child were contacted to identify the exact location of the injury. On-site measurements were made of the monkey bar apparatus including height, the distance between grips, the circumference of the grip, and ground surface type. Results Of 1968 patients seen in 2017, there were 990 upper extremity injuries and 66 monkey bar injuries (98.5% fractures). The average age of those injured on monkey bars was 6.6 ± 1.9 years, 60.6% were males. The average height of the apparatus was 207.32 ± 16.59 cm (range: 176.53-254 cm), the average distance between grips was 35.30 ± 5.62 cm, and the average circumference of the grip was 9.83 ± 1.03 cm. All exceeded the recommended height for preschool children aged 4-5 years (152.4 cm), and 11 of the 30 (36.7%) exceeded this recommended height for school-age children (213.26 cm). For the distance between grips, 23 of the 30 (76.7%) exceeded the preschool recommendation (30.48 cm), and three of 30 (13.3%) monkey bars exceeded the recommendation for school age children (38.1 cm). Conclusion Monkey bar injuries continue to be a common source of upper extremity fractures among young children. There is a high rate of non-compliance with current recommended safety standards.