Childhood injuries from stairway falls

Childhood injuries from stairway falls

Childhood Injuries from Stairway Falls Falls, primarily down stairs, are the most common cause of injury in childhood. Joffe and Ludwig report data on 363 cases of stairway injuries in children seen in a hospital emergency department. Ages ranged from one month to 18.7 years.

The vast majority of patients sustained minor soft tissue injuries. Bony injuries including fractures and significant dental injuries, accounted for only 7 percent of all injuries. Only 3 percent of the children were admitted to the hospital for one to three days. The great majority of admissions were for observation of a patient with head trauma. None of the patients had life-threatening injuries, and none required admission to the intensive care unit.

Head and neck injuries occurred in 73 percent of the cases. Children under four years of age were significantly more likely than older children to sustain head trauma. Extremity injuries were detected in 28 percent of the patients, and truncal injuries were seen in only 2 percent.

Of all fractures, 72 percent involved the extremities and 28 percent involved the skull. The majority (86 percent) of the extremity fractures were distal. There were only two fractures of the humerus and no femoral fractures. There were no rib, vertebral body or pelvic fractures.

Infants who fell while being carried on stairways by adults made up 3 percent of the series. Infants in walkers were involved in 60 percent of stairway injuries in children six months to one year of age.

Overall, there was a striking absence of serious injuries. When skull fractures occurred, patients generally did well without neurosurgical intervention. This is in contrast to children falling from windows or fire escapes, who usually sustain multiple and severe injuries, often involving the proximal extremities, pelvis, thorax and abdomen. Data from this series suggest that in children, most stairway falls consist of an initial mild to moderately severe impact followed by a series of low-energy noninjurious falls as the child tumbles down the stairs.

Severe injuries that are attributed to a fall down steps should be investigated in greater depth. In cases involving multiple injuries or injuries to the trunk or proximal extremities, a different mechanism of injury (i.e., child abuse) should be suspected. (Pediatrics, September 1988, vol. 82, p. 457.)

Tissue Injury in Children After Stairway Falls

Percentage

Injury of patients

None detected 11

Soft tissue

Abrasion or contusion 55

Laceration 26

Bony tissue

Fracture 6

Dental 1

Central nervous system

Concussion 1

Contusion/bleeding 0

COPYRIGHT 1989 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group