Barlow (1983) and Roshkow (1990) both studied falls from heights, again in older patients. Barlow found that the shortest falls that resulted in death were from approximately 30 feet. Roshkow had slightly different findings: that the pattern of injury, including the presence of a head injury, did not relate to the height of the fall and that significant head injury was not uncommon after falls from heights >10 feet.
Tarantino (1999) studied 167 patients 10 months of age or younger who sustained vertical falls 4 feet or lower. Fifteen percent of patients suffered significant injuries including seven long bone fractures and 12 linear skull fractures. The patients had evaluation for inflicted injury (but some information was lacking or omitted, i.e., skeletal surveys). The authors also found that a child with significant injury was more likely to have been dropped from the arms of a caretaker (p=.003). In this study, no child sustained a significant intracranial injury from a short vertical fall.
Williams (1991) reports on 106 children who fell from a height of less than 10 feet and were witnessed by a non-caretaker. Three children in this series suffered a depressed skull fracture from falling against surfaces. All of the children in this series are older, which limits the applicability to infants.
Leventhal (1993) found that it is common for children to suffer fractures from falls (60 percent of children in their study sustained a fracture from falls). The greater the height of the fall, the more common it was to incur a skull fracture.
Rivara (1993), Kim (2000), Warrington (2001), Johnson (2005), Pitone (2006), Thompson (2010) all reviewed children who suffered falls. They all found that young children do not typically sustain severe or life-threatening injuries from falls. Falls from greater heights can result in more injury.
Read the article summaries about free / vertical falls.