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Gina E. Bertocci, PhD; Mary Clyde Pierce, MD; Ernest Deemer, MS; Fernando Aguel, BS

Arch Pediatr Adolesc Med. 2001;155:1008-1014.

Objectives  To demonstrate the usefulness of computer simulation techniques in the investigation of pediatric stair falls. Since stair falls are a common falsely reported injury scenario in child abuse, our specific aim was to investigate the influence of stair characteristics on injury biomechanics of pediatric stair falls by using a computer simulation model. Our long-term goal is to use knowledge of biomechanics to aid in distinguishing between accidents and abuse.

Methods  A computer simulation model of a 3-year-old child falling down stairs was developed using commercially available simulation software. This model was used to investigate the influence that stair characteristics have on biomechanical measures associated with injury risk. Since femur fractures occur in unintentional and abuse scenarios, biomechanical measures were focused on the lower extremities.

Results  The number and slope of steps and stair surface friction and elasticity were found to affect biomechanical measures associated with injury risk.

Conclusions  Computer simulation techniques are useful for investigating the biomechanics of stair falls. Using our simulation model, we determined that stair characteristics have an effect on potential for lower extremity injuries. Although absolute values of biomechanical measures should not be relied on in an unvalidated model such as this, relationships between accident-environment factors and biomechanical measures can be studied through simulation. Future efforts will focus on model validation.

From the Departments of Bioengineering (Dr Bertocci and Mssrs Deemer and Aguel), Rehabilitation Science and Technology (Dr Bertocci and Mssrs Deemer and Aguel), and Pediatrics (Drs Bertocci and Pierce), Childrens' Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa.

Corresponding author and reprints: Gina E. Bertocci, PhD, University of Pittsburgh, Rehabilitation Science and Technology, 5044 Forbes Tower, Pittsburgh, PA 15260 (e-mail: ginaber{at}pitt.edu).

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