Patterns of Injury Associated With Routine Childhood Falls

Abstract

To identify the pattern of injuries associated with routine childhood falls. Retrospective chart review of patients at most 12 years presenting to a children's hospital emergency department with complaint of a fall. Patients were classified into 3 age groups (<2, 2-4, and 5-12 years) and analyzed for the type of fall and diagnosis. Seven hundred eighty-seven patients were enrolled. Mean age was 5.7 years. Fifty-six percent were boys. The types of falls reported were categorized as a fall down steps, from patient's own height, from an object, and other. In all 3 groups, the most common fall was fall from an object (50%, 50%, and 48%, respectively). There were 91 (12%) patients in the younger-than-2-year-old age group and 235 (30%) in the 2- to 4-year-old age group. Both groups commonly fell from a bed/chair (35% and 25%, respectively). In the youngest group, the most frequent diagnosis was head injury (41%; odds ratio [OR], 5.0; 95% confidence interval [CI], 3.0-8.1). Children ages 5 to 12 years numbered 461 (58%) and most commonly fell from playground equipment (26%) sustaining a fracture (65%; OR, 3.1; 95% CI, 2.3-4.3). Of these, 77% were in the upper extremity (arm fracture; OR, 41; 95% CI, 22-79). In children who presented to a children's hospital emergency department with a fall, fall from an object was the most common type. Those younger than 2 years, most commonly fell from a bed/chair and sustained head injury. Children 5 to 12 years old were likely to fall from playground equipment and fracture their arm. These findings may be helpful to clinicians who evaluate routine childhood falls.