[When children fall]

Second only to traffic accidents, accidental falling is the most significant cause of death in children. Included in this category is a special group of accidents--falling from a height--where preventative measures would give good results. Cases of child abuse have also been found in this group. From 1989 to 1994 64 children, 19 girls and 45 boys, were treated in our surgical department after accidental falls. There were 99 injuries in all, most of them caused by falls from heights less than 2.5 m. Only two children suffered penetrating injuries. Two of the 64 children died from cerebral injuries after falling from great heights. One child died from heart tamponade, caused by rupture of the right auricle after falling down a steep staircase. One child survived a fall from a great height despite multiple injuries. In such cases, treatment is dependent on a multiple trauma team being available on a 24-hour basis. Measures to prevent falls in the home, as well as in children's playgrounds and in kindergartens are not only very important, but also easy to apply. Suspicion of child abuse must be raised where unusual injuries are observed in children who have reportedly fallen from low heights.