INFANT WALKER-RELATED INJURIES - A PROSPECTIVE-STUDY OF SEVERITY AND INCIDENCE

Objective. To determine the incidence and significance of walker-relat ed injuries in infants. Methods. During a 3-year, 8-month period, all infants who were brought to the University of Virginia Pediatric Emerg ency Department with a walker-related injury were prospectively studie d. During the emergency department visit, demographic and epidemiologi c information were recorded. The annual incidence of walker-related in juries 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-fiv e patients were enrolled in the study. The age distribution ranged fro m 3 months to 17 months, with 95% younger <1 year old. Mechanisms asso ciated with walker-related injuries included stairway falls in 46 infa nts (71%), tip-overs in 14 infants (21%), falls from a porch in 2 infa nts (3%), and burns in 3 infants (5%). These injuries predominantly in volved the head and neck region (97%), with few injuries to the extrem ities (6%) and trunk (3%). Although the majority of injuries were mino r, significant injuries occurred in 19 infants (29%). These injuries i ncluded skull fracture, concussion, intracranial hemorrhage, full-thic kness burns, c-spine fracture, and death. After excluding the burned p atients, all the serious injuries resulted from falls down stairs. The annual incidence of injuries occurring in infants <1 year of age, rel ated to the use of walkers, and resulting in an emergency department v isit was 8.9/1000, and for serious injuries was 1.7/1000. Conclusions. The incidence and significance of infant walker-related injuries in i nfants are unacceptably high.