L C M E D S O C .O R G
Summer Fun
AND STRADDLE INJURIES PATRICIA MARAN, MD, FACOG
A
s the snow drops begin to open, and the crocus tips peek through the soil, I start to hear children playing outside. I am lucky to live in a neighborhood where kids still venture outside. As a former teacher and sports coach turned gynecologist, I am slightly more apprehensive watching kids begin to play this year. Two years of Covid restrictions have deconditioned us all.
Let me explain. A common reason for me to get called to the ER during spring and summer months is to fix straddle injuries: think little children slamming down on their privates. Jungle gyms, backyard balance beams, rope swings, water parks, and bicycles all keep me busy on warm sunny evenings. Just as academic and social skills have been altered for our children so too have fundamental movement skills. Our children are two years taller and heavier, unaccustomed to these bodies, and potentially delayed in learning kinesthetic skills such as skipping, climbing, jumping, peddling, and swimming. STRADDLE INJURIES Typical injuries resulting when a child slips or missteps and falls, splitting the legs and causing damage to the genital region. Often these injuries can be categorized as laceration, abrasion, bruise, or trauma. Below I will discuss categories of injuries and preventative suggestions. Balance changes as children grow; their center of gravity moves during growth spurts. Learning basic activities becomes more difficult the further we are from the ground, making balance beams and jungle gyms my nemesis. Lack of estrogen in prepubescent girls prevents the labia from having any cushion or padding so when they fall, the proximity of bone to skin makes pelvic injuries bleed like facial injuries. I have had a challenging
time putting “lady parts” back together after these falls because unlike obstetric injuries of adult women, there is no “extra” skin or folds or fat to help with the repair. Ultimately, while children heal quickly with no marked cosmetic or structural defects, it is exceptionally difficult to keep an elementary child from “playing” for a week during postoperative recovery. Rule 1: Wear shorts that cover the entire underwear and inner thigh. Don’t play in sundresses and bathing suits without board or bike shorts. Rule 2: Avoid biking with flip flops; the feet easily slip off the pedals, and bike cross bars have the potential to make mincemeat of the genitalia. Bikes have been difficult to buy for supply chain deficits, so children are often using older siblings’/neighbors’ bikes increasing susceptibility to injury. Helmets, footwear, and proper shorts are likely the most important safety features for little ones. If your child has injured themselves and you find blood in their groin or on underwear and garments, regardless of how long ago this might have happened, please get this assessed. It’s infinitely easier to fix these genital cuts sooner rather than later. Remember oftentimes children will show doctors and nurses before they might show parents, so encourage them to be honest with health care providers. GENITAL HEMATOMAS A purple bruise, possibly expanding, found in the genital region likely after a fall, kick, sports injury or “rough-housing.” Continued on page 16 SPRING 2022 | Lehigh County Health & Medicine 15
