When that first snowfall hits, kids naturally race outside with their favorite snow gear, but all that enthusiasm could turn into a trip to the hospital emergency room. More than 67,843 injuries related to sledding and snow tubing were treated at hospital emergency rooms last year. The majority of injuries occur among youths under age 15.

Some sledding injuries can cause lifelong disability or death, in addition to broken bones, lacerations and bruises. "It is particularly important that children under age 12 wear a helmet when sledding to help reduce their risk of severe head injury in a crash," announced Vernon T. Tolo, MD, president of the American Academy of Orthopaedic Surgeons and pediatric orthopaedic surgeon at Children's Hospital in Los Angeles. "Young children are very vulnerable to head injuries, with proportionately larger heads and higher centers of gravity than older youth," explained Dr. Tolo. "Their coordination is not fully developed, so they can have difficulty avoiding obstacles."

Adult supervision is also important, especially to make sure children don't collide with others at the bottom of the hill and that the end of the path is not in a parking lot or other hazardous area.

The American Academy of Orthopaedic Surgeons offers the following tips for preventing sledding injuries: *Children age 12 and under should wear a helmet. Any helmet available is helpful. Bicycle helmets may be the only choice, but they vent heat--so a fleece or wool cap should be worn underneath.*Do not sled on slopes that end in a street, drop off, parking lot, river or pond.*Sit in a forward-facing position -- do not slide head first!*Steer with your feet, or a rope tied to the steering handles of the sled.*Sled only in designated and approved areas such as parks where there are lanes and no trees.*Young children should be supervised by a parent or an adult.*Wear layers of clothing for protection from injuries and cold.*Sled in well-lighted areas.*Stay alert and aware of other sledders.

Internet users can find additional information on preventing sledding and other winter sports injuries at the American Academy of Orthopaedic Surgeons' web site, www.aaos.org, or call the Academy's Public Service line at 800-824-BONES.

An orthopaedic surgeon is a physician with extensive training in the diagnosis and non-surgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.

The 26,047-member American Academy of Orthopaedic Surgeons (www.aaos.org) or (http://orthoinfo.aaos.org), is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (http://www.boneandjointdecade.org/us), the global initiative in the years 2002-2011 to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life. President Bush has declared the years 2002-2011 National Bone and Joint Decade in support of these objectives.