title: 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.
authors.affiliation: Dept of Pediatrics, University of Virginia, Charlottesville 22908.
authors.forename: C T
authors.initials: CT
authors.lastname: Chiaviello
authors.forename: R A
authors.initials: RA
authors.lastname: Christoph
authors.forename: G R
authors.initials: GR
authors.lastname: Bond
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D015370:Infant Equipment / Q000009:adverse effects*; D019838:Neck Injuries; D011446:Prospective Studies; D014768:Virginia / Q000453:epidemiology