Introduction
The selfie phenomenon has exploded worldwide over the past two years. A selfie is now defined in the Oxford dictionary as ‘a photograph that one has taken of oneself, typically one taken with a smartphone or webcam and shared via social media’. Selfies have been linked to a large number of mortalities and significant morbidity worldwide. However, trauma associated with selfies including fractures, is rarely publicized. Here we present a case series of upper extremity trauma secondary to selfies across all age groups during the summer period. This case series highlights the dangers associated with taking selfies and the trauma that can result.

Case Report

Case1:
A 13-year-old girl on a trampoline with one friend attempted to take a selfie while jumping on the trampoline. The smart phone was held in the left non-dominant hand, as the patient was focusing on taking the photo she collidewith the other person on the trampoline. She then fell onto her right hand, and suffered a fracture of the right distal radius and ulna (Image 1). She was neurovascularly intact and no other injuries were noted. She was treated with manipulation under anaesthesia and cast for six weeks.

Case 2:
A 17-year-old female while running along a seaside promenade, fell while attempting to take a selfie running up steps. She placed her left hand out to protect her face and sustained a fracture to the distal radius, with minimal displacement and angulation. She was treated non operatively in cast for 6 weeks.

Case 3:
A 27-year-old female sportsplayer suffered a fractured left distal radius after a fall out with friends. Attempting to take a selfie with her left hand, with a group of her teammates on stairs. She fell down four steps and put her dominant right hand forward. She suffered an impacted volarly displaced distal radius fracture that was treated with open reduction internal fixation.

Case 4:
A 40-year-old female was walking on uneven ground at a well known tourist attaction. While attempting to take a selfie, she took two steps backwards and had a fall on rocks. This right hand dominant lady suffered a right distal radius fracture with dorsal angulation. Neurovascular assessment was normal. She had no other injuries. She underwent Krischner wire fixation (K-wire).These K-wires were removed at 4 weeks.

Discussion
All cases presented during a one week period which raised our curiousity. No hospital inpatient enquiry (HIPE) data is available for selfie-related injuries as currently no ICD-10 classification exists. All photographs were taken using a smartphone; not a standard camera. In our case series, we have found all selfie-related trauma resulted in distal radius fractures. All patients fractured the limb not holding the smartphone, suggesting that selfie-takers value and are protective of their smartphone. Interestingly, despite their widespread use, no additional props such as selfie sticks were involved. As social media platforms promote and popularises selfies, the associated hazards and potential injuries need to be reported and published. While taking selfies, proprioception and spatial awareness is often poorer, as attention is focused on a mobile device. This can lead to trauma, resulting in hospitalisation. In our institution, we have noted an increase in the past number of months of selfie-related trauma. This phenomenon is similar to the increase in paediatric fractures associated with trampolines and fitness computer game-related trauma documented over the past two decades^1-4. To combat this increase in trauma figures, education about the hazards of these practices needs to be implemented. The Internal Ministry of Russia recently published a ‘Safe Selfie Guide’ to educate the public on taking selfies⁵.This was instituted after a number of fatalities were attributed to taking a selfie, including a fall from a cliff. Taking selfies is now considered the norm worldwide. The consequences of poorer spatial awareness and a focus on getting a good or daring photo has lead to mutlipe traumas reported in the newspapers inlcuding The Daily Telegraph (UK)⁶, but this is the first medial case series documenting this mechanism of injury. It is important to educate society about the risks associated with taking selfies in order to reduce both major and minor trauma associated with the new trend.   

 

Conflict of Interest
No author has a conflict of interest to declare.

Corresponding Author:
Rebecca Lyons, Department of Trauma and Orthopaedic Surgery, UCHG, Galway Universtiy Hospitals, Galway.
Email: [email protected]

 

References

1.Smith G. ‘Injuries to Children in the United States Related to Trampolines, 1990–1995: A National Epidemic’Pediatrics, 1998 ;101(3) 406-12
2. Eberl R, Schalamon J, Singer G, Huber SS, Spitzer P, Höllwarth ME. ‘Trampoline-related injuries in childhood.’ European Journal of Pediatrics2009: 168(10)1171-1174
3. Hirpara KM, Abouazza OA, ‘The ‘‘Wii Knee’’: A case of patellar dislocation secondary to computer video games.’ Injury Extra (2008) 39, 86-87
4.Sparks D, Chase D, Coughlin L. ‘Wii have a problem: a review of self-reported Wii related injuries.’ Informatics in Primary Care 2009;17:55–7
5.The Ministry of Internal Affairs of the Federation of Russia. ‘Safe Selfie’, Moscow 2015.
6. Soo,K . ‘Tourist dies at India’s Taj Mahal while taking a selfie.’ The Daily Telegraph 2015, September 8th. Travel Section

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