One Big Bounce
Author: Mark Hopkins, MD
Peer-Reviewer: Alex Tomesch, MD
Final Editor: Alex Tomesch, MD
A 5 year old male presents with right leg pain and limp. Parents report it started after he was bouncing on the trampoline with his older sibling but deny any specific trauma. He has tenderness over his proximal shin with no obvious injury.
What is your diagnosis?
Transverse fracture of the proximal tibial metaphysis, otherwise known as trampoline fracture.
Image 1 (AP) and 2 (lateral). Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID: 16139, annotations by author
What is the typical mechanism of injury?
This fracture typically occurs when a child is bounced by a larger individual on a trampoline or bouncy house (See Image 3). As the larger individual lands, the force of the springing surface travels through the child's leg, creating an impact fracture [1].
- Pearl: Typical age is 2-5 due to an immature skeleton and lack of coordination [1]
Image 3. Illustration by Tabitha Ford, MD
References
[1] G.A. Smith, B.J. Shields. Trampoline related injuries to children. Arch Ped Adoles Med, 152 (1998), pp. 694-699