Computer simulation of stair falls to investigate scenarios in child abuse

Objectives: To demonstrate the usefulness of computer simulation techniques in the investigation of pediatric stair falls. Since stair falls are a com mon falsely reported injury scenario in child abuse, our specific aim was t o investigate the influence of stair characteristics on injury biomechanics of pediatric stair falls by using a computer simulation model. Our long-te rm goal is to use knowledge of biomechanics to aid in distinguishing betwee n accidents and abuse. Methods: A computer simulation model of a 3-year-old child falling down sta irs was developed using commercially available simulation software. This mo del was used to investigate the influence that stair characteristics have o n biomechanical measures associated with injury risk. Since femur fractures occur in unintentional and abuse scenarios, biomechanical measures were fo cused on the lower extremities. Results: The number and slope of steps and stair surface friction and elast icity were found to affect biomechanical measures associated with injury ri sk. Conclusions: Computer simulation techniques arc useful for investigating th e biomechanics of stair falls. Using our simulation model, we determined th at stair characteristics have an effect on potential for lower extremity in juries. Although absolute values of biomechanical measures should not be re lied on in an unvalidated model such as this, relationships between acciden t-environment factors and biomechanical measures can be studied through sim ulation. Future efforts will focus on model validation.