title: River tree rope swing injuries.
abstract: OBJECTIVE
  To review injuries associated with falls from river tree rope swings (RTRS) and identify points of action for prevention.
  
  
  METHODS
  This study was a retrospective analysis of injury reports directly related to falls from RTRS. Case reports for 2002-06 were extracted from the National Electronic Injury Surveillance System (NEISS), US legal literature, and news reports. Direct observation of river tree rope swings was performed with kayak and camera to identify potential hazards. A laboratory study was performed on samples of rope used in RTRS to assess entanglement risk.
  
  
  RESULTS
  NEISS detailed 73 injuries directly related to falls from RTRS in ages 5-25 years. Finger fractures were the most commonly reported injury. Based on NEISS data, an estimated 700 injuries may occur related to RTRS each year. RTRS share risk of severe injuries with traditional rope swings such as lower extremity fractures, concussions, and spinal cord injuries. Drowning, finger avulsion and genital lacerations appear more common with river tree rope swings.
  
  
  CONCLUSIONS
  RTRS are dangerous and are associated with a variety of serious injuries from falls and entanglement. The most hazardous risk factors of RTRS are use by a non-swimmer, shallow water, extreme fall distance, and presence of a small diameter retrieval line. RTRS injuries occurring in remote locations are challenges to rural physicians and EMS providers. Prevention of recreational injuries, including injuries sustained from RTRS, remains a daunting task.
authors.affiliation: Department of Pediatrics, University of Mississippi School of Medicine, Jackson, MS 39216, USA. wsorey@ped.umsmed.edu
authors.forename: William H
authors.initials: WH
authors.lastname: Sorey
authors.forename: Laura D
authors.initials: LD
authors.lastname: Cassidy
authors.forename: Jeffery
authors.initials: J
authors.lastname: Crout
authors.forename: Phillip
authors.initials: P
authors.lastname: Blount
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004332:Drowning / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D010988:Play and Playthings / Q000293:injuries*; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D013550:Swimming / Q000293:injuries*; D014481:United States / Q000453:epidemiology; D055815:Young Adult