Injuries when children reportedly fall from a bed or couch

One-hundred-fifteen patients with orthopaedic injuries resulting from a reported fall from a piece of furniture at home were studied to define the relationship of suspected child abuse associated with this mechanism of injury. One hundred-thirteen patients sustained fractures or dislocations and two patients were impaled with a pencil and a needle. Each patient was evaluated by a primary care physician or an emergency room physician and by an orthopaedic surgeon. In six of 115 patients (5%), a treating physician filed a child abuse report. In 109 patients (95%) the purported mechanism of injury was considered sufficient to produce the resulting injury. Two of four children younger than 1 year (50%), four of 83 children 1 to 5 years (5%), and none of the 28 children older than 5 years were investigated for potential child abuse. Orthopaedic injuries reportedly attributable to a child falling from a bed or couch at home usually are accidental unless the child is younger than 1 year.