Original Article

River Tree Rope Swing Injuries

Authors: William H. Sorey, MD, FAAP, Laura D. Cassidy, PhD, Jeffery Crout, MD, FAAP, Phillip Blount, MD


Objective: To review injuries associated with falls from river tree rope swings (RTRS) and identify points of action for prevention.

Methods and 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.

Key Points

* River tree rope swings (RTRS) are dangerous.

* Cervical spine injuries may occur with dives from RTRS.

* Drowning is the most common cause of death related to RTRS.

* Hazardous features of RTRS are shallow water, extreme fall height, use by a nonswimmer, and presence of a small diameter retrieval line.

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