Potential for head injuries in infants from low-height falls

Laboratory investigation

Brittany Coats Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania

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Susan S. Margulies Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania

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Object

Falls are the most common accident scenario in young children as well as the most common history provided in child abuse cases. Understanding the biomechanics of falls provides clinicians with objective data to aid in their diagnosis of accidental or inflicted trauma. The objective of this study was to determine impact forces and angular accelerations associated with low-height falls in infants.

Methods

An instrumented anthropomorphic infant surrogate was created to measure the forces and 3D angular accelerations associated with falls from low heights (0.3–0.9 m) onto a mattress, carpet pad, or concrete.

Results

Although height significantly increased peak angular acceleration (αp), change in peak-to-peak angular velocity, time duration associated with the change in velocity, and peak impact force (Fp) for head-first drops onto a carpet pad or concrete, none of these variables were significantly affected by height when dropped onto a mattress. The αp was not significantly different for drops onto a carpet pad and concrete from 0.6 or 0.9 m due to compression of the carpet pad. Surprisingly, sagittal αp was equaled or surpassed by axial αp.

Conclusions

These are the first 3D angular acceleration and impact force data available for head impact in infants from low-height falls. A future study involving a computational model of the infant head will use the loads measured in this study to predict the probability of occipital skull fracture on impact from head-first low-height falls. Together, these studies will provide data that will aid clinicians in the evaluation of accidental and inflicted head injuries, and will contribute to the design of safer environments for children.

Abbreviations used in this paper:

αp = peak angular acceleration; ANOVA = analysis of variance; DAI = diffuse axonal injury; Δt = time duration associated with change in angular velocity; Δω= peak-to-peak change in angular velocity; F p = impact force; ROM = range of motion; SNK = Student-Newman-Keuls.
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