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:

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.