Objective. To identify the pattern and severity of injury associated w
ith stairway-related falls in children. Methods. During a 2-year perio
d, all children less than 5 years of age presenting to the University
of Virginia Pediatric Emergency Department with a stairway-related inj
ury were prospectively studied. At the time of the emergency departmen
t visit, demographic and epidemiologic information was obtained. Injur
ies were assigned E codes and N codes. A Modified Injury Severity Scal
e (MISS) score was calculated for each child. Excluded from the study
were children with suspected intentional trauma and children with walk
er-related stairway injuries. Results. Sixty-nine children were enroll
ed in the study. The median age was 2 years. Head and neck injuries oc
curred in 90% of the patients, extremity injuries in 6%, and truncal i
njuries in 4%. Injury to more than one body region did not occur. The
majority of injuries were minor. Ninety-six percent had a total MISS s
core less than or equal to 2. Fifteen patients (22%) suffered signific
ant injuries, including concussion in 11 (16%), skull fracture in 5 (7
%), cerebral contusion in 2 (3%), subdural hematoma in 1 (1%), and a C
-2 fracture in 1 (1%). Conclusions. The majority of stairway-related i
njuries are minor. Injuries to the head and neck region predominate. I
njuries to multiple body regions are rare. However, significant stairw
ay-related injuries may be more common than previously reported.