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Background: When attempting to determine whether a child’s injuries are accidental or nonaccidental, biomechanical evidence is needed to determine the likelihood of observed injuries being associated with the stated cause. Household falls are a commonly reported accidental injury mechanism as well as a common falsely reported cause in cases of abuse. Femur fractures can result from household falls, but in non-ambulatory children, femur fractures are more likely to be non-accidental. Previous testing with a modified CRABI 12-month-old anthropomorphic test device (ATD) with an improved biofidelic femur was conducted to measure femur loading in experimentally simulated falls from a bed and feet-first falls from a height. Different fall configurations included two impact surfaces (linoleum and carpet) for both fall types and two fall heights (69cm and 119cm) for the feet-first falls. A finite element (FE) model of the pediatric femur was developed and used to evaluate the potential fracture risk based on loading conditions from ATD experimental fall data. The objectives of this study are to evaluate femur stress and strain associated with common household falls and to compare these outcomes to fracture thresholds to determine fracture potential.

Investigating the likelihood of pediatric femur fracture due to falls through finite element analysis.