Infant Walker-Related Injuries: A Prospective Study of Severity and Incidence

Abstract

Objective. To determine the incidence and significance of walker-related injuries in infants. Methods. During a 3-year, 8-month period, all infants who were brought to the University of Virginia Pediatric Emergency Department with a walker-related injury were prospectively studied. During the emergency department visit demographic and epidemiologic information were recorded. The annual incidence of walker-related injuries occurring in infants <1 year of age that resulted in a hospital emergency department visit was calculated from the home zip codes of the injured patients and from the population of infants <1 year of age living in Charlottesville and in Albemarle County. Results. Sixty-five patients were enrolled in the study. The age distribution ranged from 3 months to 17 months, with 95% younger <1 year old. Mechanisms associated with walker-related injuries included stairway falls in 46 infants (71%), tip-overs in 14 infants (21%), falls from a porch in 2 infants (3%), and burns in 3 infants (5%). These injuries predominantly involved the head and neck region (97%), with few injuries to the extremities (6%) and trunk (3%). Although the majority of injuries were minor, significant injuries occurred in 19 infants (29%). These injuries included skull fracture, concussion, intracranial hemorrhage, full-thickness burns, c-spine fracture, and death. After excluding the burned patients, all the serious injuries resulted from falls down stairs. The annual incidence of injuries occurring in infants <1 year of age, related to the use of walkers, and resulting in an emergency department visit was 8.9/1000, and for serious injuries was 1.7/1000. Conclusions. The incidence and significance of infant walker-related injuries in infants are unacceptably high.