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Published on: September 21, 2017
Pediatric short-distance household falls: biomechanics and associated injury severity
Angela K Thompson1, Gina Bertocci, Wayne Rice
1Mechanical Engineering, University of Louisville, Louisville, KY 40202, USA. angela.thompson@louisville.edu
Insights
Short-distance household falls in young children rarely cause severe injuries. Biomechanical factors like height and impact velocity correlate with injury severity, aiding medical assessments.
Area of Science:
- Pediatric Traumatology
- Biomechanics of Injury
- Child Abuse Prevention
Background:
- Short-distance household falls are common in young children.
- Such falls are sometimes a misrepresentation of abusive trauma.
- Understanding injury patterns from accidental falls is crucial for accurate diagnosis.
Purpose of the Study:
- To determine the severity of injuries from accidental short-distance household falls in children.
- To investigate the association between fall environment, biomechanical measures, and injury outcomes.
Main Methods:
- Study included children aged 0-4 years presenting to the ED with a history of a short furniture fall.
- Biomechanical assessments utilized medical records, interviews, and fall scene investigations.
- Injuries were classified using the Abbreviated Injury Scale (AIS); cases with suspicious histories were excluded.
Main Results:
- Of 79 subjects, 15 had no injuries, 45 minor (AIS 1), 17 moderate (AIS 2), and 2 serious (AIS 3).
- No fatalities or injuries classified as AIS 4 or higher occurred.
- Children with moderate/serious injuries fell from greater heights with higher impact velocities and had lower BMIs.
Conclusions:
- Short-distance household falls in children aged 0-4 do not typically result in severe or life-threatening injuries.
- Biomechanical measures are significantly associated with injury severity in these fall incidents.
- This knowledge assists clinicians in differentiating accidental falls from non-accidental trauma.
Objectives:
Short-distance household falls are a common occurrence in young children, but are also a common false history given by caretakers to conceal abusive trauma. The purpose of this study was to determine the severity of injuries that result from accidental short-distance household falls in children, and to investigate the association of fall environment and biomechanical measures with injury outcomes.
Methods:
Children aged 0-4 years who presented to the Emergency Department with a history of a short furniture fall were included in the study. Detailed case-based biomechanical assessments were performed using data collected through medical records, interviews, and fall scene investigations. Injuries were rated using the Abbreviated Injury Scale (AIS). Each case was reviewed by a child abuse expert; cases with a vague or inconsistent history and cases being actively investigated for child abuse were excluded.
Results:
79 subjects were enrolled in the study; 15 had no injuries, 45 had minor (AIS 1) injuries, 17 had moderate (AIS 2) injuries, and 2 had serious (AIS 3) injuries. No subjects had injuries classified as AIS 4 or higher, and there were no fatalities. Children with moderate or serious injuries resulting from a short-distance household fall tended to have fallen from greater heights, have greater impact velocities, and have a lower body mass index than those with minor or no injuries.
Conclusion:
Children aged 0-4 years involved in a short-distance household fall did not sustain severe or life-threatening injuries, and no children in this study had moderate or serious injuries to multiple body regions. Biomechanical measures were found to be associated with injury severity outcomes in short-distance household falls. Knowledge of relationships between biomechanical measures and injury outcomes can aid clinicians when assessing whether a child's injuries were the result of a short-distance fall or some other cause.
