Biomechanics and injury assessment of household falls in children : clinical, anthropomorphic surrogate, and computer simulation studies.

Biomechanics;Pediatric falls;Child abuse;Pediatric injury

Angela Knight Thompson

University:University of Louisville

Department:Mechanical Engineering

关键词: Biomechanics;    Pediatric falls;    Child abuse;    Pediatric injury;   

Others  :  https://ir.library.louisville.edu/cgi/viewcontent.cgi?article=2434&context=etd

美国|英语

来源: The Universite of Louisville's Institutional Repository

【 摘 要 】

Pediatric short-distance falls, especially from beds or other furniture, are commonfalse histories given by caretakers to cover up abusive trauma. However, short-distancefalls are also a common occurrence in young children. Knowledge of the types andseverity of injuries that can result from these short falls can aid clinicians indistinguishing between inflicted and non-inflicted injuries. Early detection of abuse maylead to prevention of further escalating injuries and, in some cases, prevent the death ofthe child. The purpose of this study was to describe relationships between biomechanicalmeasures and injury potential in short-distance household falls. This study involved threecomponents: case-based biomechanical fall assessments, fall simulations using ananthropomorphic test device (ATD), and development/validation of a computersimulation model used to investigate sensitivity of injury outcome measures to fallenvironment and child surrogate parameters. Overall, the risk of severe or life-threatening injury in short-distance householdfalls is low. Fractures of the skull and extremities commonly result from these falls (21.5% of falls resulting in Emergency Department visits). 2 of 79 fall cases involvedsmall, contact-type subdural hematomas. These subjects both had unique fall dynamicsthat contributed to their injuries. Results of ATD experiments supported those from theclinical portion of the study with the exception of neck injury potential. Future studiesare needed to both improve ATD neck biofidelity and determine more accurate pediatricneck injury thresholds. Fall environment parameters (fall height and impact surface type) have beenshown previously to influence injury potential, but this is the first study to investigate theinfluence of child or surrogate parameters (body mass index, overall mass, head stiffness,and neck properties) on injury potential. Additionally, through a parametric sensitivityanalysis, it was found that fall environment and surrogate parameters that altered falldynamics had the greatest influence on injury potential. These results highlight the needfor obtaining detailed case histories when making injury assessments that include notonly environment and child factors, but descriptions of the fall dynamics and orientationof the child upon impact with the ground.