Mayerson Center for Safe and Healthy Children

Falls from Walkers and Shopping Carts - Article Summaries

Chiaviello CT, et al. Infant walker-related injuries: a prospective study of severity and incidence . Pediatrics 1994;93:974-976.

Methods:

  • 65 patients ages 3-17 months (95 percent <1 year of age) who presented to ED with a walker-related injury
  • 46 (71 percent) fell down steps while in a walker
  • 14 (21 percent) tipped over while in a walker
  • “Infants with suspected non-accidental trauma were excluded from the study”

Results:

  • 19 (29 percent) patients had a serious injury: 10 (15 percent) skull fractures, eight (12 percent) concussions, five (8 percent) intracranial hemorrhage, two (3 percent) full thickness burns, one (2 percent) C-spine fracture
  • one patient died (infant with C-spine fracture, skull fracture and subdural hematoma)

Conclusions:

  • Majority of walker-related injuries involve the head and neck.
  • Most of serious injuries resulted from stairway falls in walkers.

Smith GA, et al. Babywalker-related injuries continue despite warning labels and public education . Pediatrics 1997;100(2) electronic

Methods:

  • 271 children 4-36 months of age (mean 9.2 months) treated in the emergency department for baby-walker related injuries

Results:

  • 26 / 271 patients had skull fractures: 17 parietal, eight frontal, one occipital
  • 3 / 26 patients had depressed skull fractures (two of these also had a second non-depressed skull fracture)
  • three patients had intracranial bleeds (two had subdurals)
  • Also: three patients with clavicular fractures and one patient had ulnar / radial fractures
  • The number of steps the child fell down was significantly associated with skull fractures
  • 14.6 percent of patients who struck concrete sustained a skull fracture compared to 8.1 percent in the non-concrete group (p=.21).

Conclusions:

  • Number of stairs a child falls down when in a walker is significantly associated with sustaining a skull fracture (independent of the influence of landing surface).
  • Extremity injuries uncommon in baby-walker-related falls.

Smith GA, et al. Injuries to children related to shopping carts . Pediatrics 1996;97:161-165.

Methods:

  • 62 children aged 4 months-10 years (mean 2.8 years) treated in the emergency department for shopping cart-related injury. 58 percent of cases fell out of the shopping cart.

Results:

  • 11 (18 percent) patients had fractures: five skull fractures, two femur fractures, one metatarsal fracture, one clavicle fracture, one distal  phalanx fracture (hand), and one radius / ulna fracture
  • 49 (79 percent) of patients had injuries to the head
  • Skull films were obtained in 11 patients (18 percent)
  • CT scan obtained in nine patients (14 percent), no abnormalities detected

Conclusion:

  • Injuries from shopping cart falls can be serious. These falls from shopping carts onto a hard non-energy-absorbing surface did not cause any serious head injury.