Patterns of injury associated with routine childhood falls

OBJECTIVE: To identify the pattern of injuries associated with routine childhood falls. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.