Background: To determine the incidence and severity of injuries caused by Heelys. Methods: A retrospective review of all fractures presenting to an orthopaedic emergency room at a metropolitan children's hospital during a 90-day period. The type of fracture, mechanism of injury, and management were recorded for each patient. For those injuries related to the use of Heelys, further data were collected including total number of visits, cast changes, and cost. Each Heelys patient/family was contacted and answered a questionnaire detailing their use of Heelys and the events surrounding the injury. Results: A total of 953 patients with fractures were evaluated for 90 days. Sixteen patients with 17 fractures (1.68%) were identified as being related to the use of Heelys. This compares to the incidence of fractures in our sample from basketball (6.19%), bicycle (4.41%), football (4.09%), monkeybars (3.78%), skateboarding (3.25%), soccer (2.62%), baseball (2.52%), and trampoline (2.31%). The average age of each Heelys patient was 8.9 years, and 13 patients were girls. There were 16 upper extremity and 1 lower extremity fracture. No patient needed operative treatment or admission. Average number of follow-up visits was 1.6, with an average of 1.4 casts per patient. Average cost per patient was $1368. Ninety-two percent of the Heelys injuries occurred outdoors. Fifty-four percent of children were being supervised when they fell, but only 31% were wearing any safety equipment. Sixty-two percent of parents were not aware that safety equipment was recommended. All 13 parents indicated that they would not purchase another pair of Heelys, and only 23% of the children wanted to keep using Heelys after the injury. Conclusions: The incidence of Heelys injuries (1.68%) was relatively low compared with other common childhood play activities. The fractures were mostly in the upper extremity, and no fracture required surgical intervention or admission to the hospital. Sixty-two percent of the parents were not aware that safety equipment was recommended, and only 31% of the children were wearing safety equipment. Level of Evidence: Level 2 cohort study.
