Things that go bump ... bump ... bump: an analysis of injuries from falling down stairs in children based at Sheffield Children's Hospital

Abstract

Background: Falls down stairs are a common presentation to the paediatric emergency department. The pattern of injury associated with this mechanism of injury has not been described for the UK population. A retrospective analysis of attendances to the Emergency Department of Sheffield Children's Hospital was carried out.

Results: Overall 90% (216/239) of patients sustained one or more injuries; 69% (165/239) sustained minor head and facial injuries; 12% (29/239) sustained minor soft tissue injuries of other regions; 10% (23/239) had limb fractures, of which 60% (14/23) were of the upper limb (nine clavicle fractures, one supracondylar fracture of the elbow and four wrist fractures) and 40% (9/23) were of the lower limb (four femoral fractures and five tibial fractures). Two per cent (5/239) had skull fractures (all were in the group of children dropped while being carried on the stairs). Injuries to more than one body part occurred in only 3% (8/239) of cases.

Discussion: The results suggest that children who fall down the stairs are mainly toddlers and in general sustain only minor injuries, the commonest being a minor head injury. Severe truncal and extremity injuries or injuries involving multiple body regions should provoke further questioning looking for evidence of non-accidental injury. There is no correlation between the number of stairs fallen down and the likelihood or severity of injury.

Conclusion: Infants who fall down stairs with their carer or are dropped while being carried down stairs require an especially close evaluation.