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Injuries caused by tripping over paving stones: an unappreciated problem.

This brief article surveys the number and type of injuries sustained by people tripping over uneven or broken paving stones, and warns that the cost of such injuries is considerable. Statistics are provided of cases which were collected retrospectively by analysis of medicolegal reports prepared by the Department of Orthopaedic Surgery at Northwick Park Hospital, Harrow during January to December 1988. Patients seen prospectively in the fracture clinic during January to March 1989 were also included. Twenty Seven factures were found in 24 patients, with one case of anterior dislocation of the shoulder. Over 150 patients are referred to fracture clinics each year for such injuries. The cost of treating such patients can be high. These figures also indicate that far more people injure themselves than actually make a claim, although the number of litigations is rising. Over 10000 claims for compensation for injuries as a direct result of tripping over broken, uneven, or loose paving stones were made against local authorities in England and Wales in 1987. Less than 40% were successful: even so, payment exceeded 10 million pounds in 1987 alone. A plea is made for local authorities to ensure that there is adequate funding for footpath maintenance.