Severity and outcome of falls in children.

Three hundred and five patients with falls over a period of 4 years were reviewed with the aim to determine the pattern, severity and outcome of childhood injuries from falls in our environment. The results showed that falls accounted for 25% of all childhood injuries. There were more male than female in ratio 2:1. The age ranges from 5 months-15 years with mean age of 6.15 years + or - 3.63. About 40% of the patients were preschool children. Home was the commonest site of falls in 55.3% followed by school in 38% of the patients. Falls from height accounted for 25% and at the ground level in 75% of the patients. Falls from stairs and storey buildings accounted for 68.3% of falls from height, whereas falls while playing on a ground level occurred in 83% of those whose falls were at ground level. Musculoskeletal injuries with fractures of bones were the commonest injuries sustained followed by head injuries. Fracture of lower limb bones accounted for 48% of all the bone injuries commonest bone being femur. The upper limb bones fractured occurred in 45.6%. There were two cases of skull fracture. Head injuries occurred in 6.2% of the patients and severe in 10% of the head injured patients. Other systemic injuries occurred rarely. Most of the injuries were trivial with Injury Severity Score ranges from 2-26. The mean Injury Severity Score was 2 in 235 patients (77%), 10.5 in 64 (21%), 12.5 in 4 (1.4%) and 21.5 in 2 patients(0.6%). Seventy-eight percent of the cases were treated as outpatient. Hospital stay ranges from 1-45 days with mean of 3.8 days. The hospital stay correlated very well with the Injury Severity Score. Wound Infection occurred in only 1.4% of the patients with mortality in 2 patients (0.6%) with Injury Severity Score of 17 and 26 respectively.