Mayerson Center for Safe and Healthy Children

  • Stairway Falls - Article Summaries

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    + Stairway injuries in children

    Joffe M, Ludwig S. Stairway injuries in children. Pediatrics 1998;82:457-461.


    • 363 patients 1 month-18.7 years of age with injuries from falls down steps who presented to the emergency department
    • Mean age was 55 months (54 patients were <1 year of age)
    • “cases of child abuse definitely identified by social workers or physicians were withdrawn”


    • 6 percent of patients had fractures: 72 percent extremity fractures and 28 percent skull fractures
    • No rib or vertebrae or pelvis or femoral fractures were seen
    • No intracranial hemorrhages or cerebral contusions were seen
    • Of infants who fell in the arms of caretakers, 40 percent (4 / 10) sustained skull fractures


    • No correlation between severity of injury and number of steps fallen down
    • Stairway injuries are much less severe than free falls of the same total vertical distance; they consist of mild-moderately severe initial impact followed by a series of low-energy non-injurious falls down the remaining steps.
    • Multiple, truncal and proximal extremity injuries are unusual in stairway falls

    + Stairway-related injuries in children

    Chiaviello CT, et al. Stairway-related injuries in children. Pediatrics 1994;94:679-681.


    • Sixty-nine children <5 years of age who presented to emergency department with history of fall down stairs
    • walker-related injuries were excluded


    • 15 (22 percent) suffered significant injuries:
      • 11 (16 percent) concussions
      • five (7 percent) skull fractures
      • two (3 percent) cerebral  contusion
      • one subdural hematoma
      • one C-2 fracture
    • Included in this group are three infants who fell while being carried:
      • one sustained a skull fracture
      • one sustained a skull fracture and brain contusion
      • one sustained a subdural hematoma


    • Significant injuries can occur when children fall down steps
    • There were more significant injuries in this study compared to Joffe’s study. This may be due to different thresholds for obtaining imaging studies in 1994 compared to 1988.

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

    Docherty E, Hassan A, Burke D.  Things that go bump . . . bump . . . bump: an analysis of injuries from falling down stairs in children based at Sheffield Children’s HospitalEmerg Med J 2010; 27:207-208.


    Retrospective analysis of emergency department visits reporting falls down stairs.


    • A total of 239 cases were found with patients aged 0 to 15 years.
    • eight patients were admitted, but none needed neurosurgical intervention, and no head injuries were significant enough to require any kind of intervention.
    • 7 percent of patients were reported to be dropped while being carried down stairs, all of which sustained injuries. 
      • A tibial fracture, two femur fractures, and five skull fractures were found in this group


    • The most common injury is to the head, but these are typically minor. 
    • The severity of injury is not associated with the number of stairs, but patients reported to have been dropped should be closely evaluated.