Scooters, rollerblades, skateboards and trampolines How to respond when a child has a fall?

The warmer months often go hand in hand with bikes, scooters, rollerblades and trampolines. While these activities are great fun, they also expose children to injuries. What should you do straight away, and which signs should ring alarm bells? MonacoSanté keeps you informed.

The most common injuries by activity

A fall from a bike, a jump on a trampoline or a tumble in a playground do not carry the same risks. Depending on the child's age and the activity involved, injuries can range from a minor scrape to a fracture or more serious trauma. This is one of the specialisms of Dr Anne Noaro Opprecht, a paediatric orthopaedic surgeon at Princess Grace Hospital (CHPG), who sees children and their parents in her clinic. In younger children, the upper limbs are most commonly affected. "Young children who fall off a scooter or a bike tend to land on their wrists and hands. Fractures are very common", she explains. Play structures are also a frequent cause of elbow fractures, while trampolines more often lead to ankle sprains or injuries. In teenagers, the risks shift as their activities and interests change. "Mountain biking, for example, carries a higher risk of head or spinal injuries, because speeds are greater."

Observe before you act

When a child falls, the instinct is often to rush over and pick them up. Yet this should be avoided, especially if no one witnessed the fall. Dr Anne Noaro Opprecht stresses the importance of taking a moment to observe. A child with no serious injury will generally try to get back up on their own. This precaution helps avoid aggravating a potential spinal or head injury. Not every fall requires a medical consultation. "If the child gets up, walks normally and is not in significant pain or showing any visible deformity, simple monitoring is usually enough." If the child remains on the ground, is unconscious, or is complaining of severe pain in the back, pelvis or abdomen, the emergency services should be called immediately (the fire brigade on 18 or 112), the child should not be moved, and they should not be given anything to eat or drink. After a blow to the head, certain symptoms call for prompt medical attention: loss of consciousness, even briefly, vomiting, persistent headaches, unusual drowsiness, changes in behaviour, and difficulty walking or speaking. These signs most often appear within 12 to 24 hours of the accident. The doctor also draws attention to a trauma that is sometimes underestimated: a handlebar impact to the abdomen. "After a significant impact, even if the child seems fine, it is advisable to go to A&E." Some internal injuries to the liver or spleen can indeed go unnoticed at first.

Good habits to instil from an early age

The level of risk depends less on the activity itself than on whether safety rules are followed. Trampolines, which are often singled out, are not necessarily more dangerous than other equipment. "If the safety rules are respected, serious injuries are rare." These rules are straightforward: one person on the mat at a time, a safety net in place, and no somersaults or acrobatics without specialist supervision. "When several children jump at the same time, the risks increase significantly: collisions, awkward landings and sprains become far more frequent." When cycling, scooting, rollerblading or skateboarding, a helmet should always be worn. "A child should never take part in any wheeled activity without protection, even for just a couple of metres." The aim is to make this a habit from the earliest age. "Making an exception, even for a short trip, muddies the message." The helmet must also fit properly. Wrist guards are particularly recommended for rollerblading, where falls onto the hands are very common. Knee pads can also help prevent certain injuries, depending on the activity.

Are children's bones more fragile?

A child's skeleton is not simply a miniature version of an adult's. Until growth is complete, around the age of 14 in girls and 16 to 17 in boys, bones have particular characteristics. "Children develop types of fractures that do not occur in adults, sometimes after relatively minor impacts." One example is the so-called "buckle fracture" (also known as a "torus fracture"), common after a a fall from a scooter. "These are small compressions of the bone with no fracture line. They generally heal fairly quickly and without lasting effects. Children have a significant capacity for bone remodelling, which allows certain deformities to correct themselves during growth", explains the paediatric orthopaedic surgeon. That said, a fracture is by no means trivial: the pain is often considerable, and immobilisation remains necessary. Depending on the type of injury, the child's age and the level of discomfort, treatment can range from a simple splint to full immobilisation. "Immobilisation also has a pain-relieving effect, as it mainly helps the child to feel less pain." Some fractures heal within three or four weeks, while forearm fractures in older children may require up to three months of immobilisation. "Physiotherapy, however, is rarely routine in younger children, as they almost never suffer from joint stiffness after having a cast removed."

Don't panic, but do stay alert

Even when a fall looks alarming, it should not automatically cause panic. "Young children fall all the time. The key is to observe them carefully, and to look for signs of pain, deformity, bruising or swelling." In very young children, who sometimes struggle to express pain, one sign is particularly telling: a child who flatly refuses to put weight on a foot or to use an injured limb should be seen by a doctor. The specialist's key message remains one of prevention. "You cannot stop children from living their lives and playing. But by following safety rules, the risk becomes much lower." Wearing a helmet at all times, using appropriate protective equipment, following safety guidelines and keeping a close eye on a child after a fall will, in the vast majority of cases, turn a simple accident into nothing more than an unpleasant memory, with no lasting consequences.