In many forensic cases, the job of forensic pathologists and anthropologists is to determine whether pediatric death is due to an abusive act or an accidental fall. The goal of this study was to compare the cranial fracture patterns generated on the parietal bone of a developing, infant porcine pig, Sus scrofa model by a controlled energy head drop onto a plate versus previous data generated by blunt force impact at the same energy onto the head constrained to a plate. The results showed that blunt force impacts on a head constrained to a rigid plate produces more fracture, but the same general pattern, as that for a head dropped onto the plate with the same level of impact energy. The study suggests that head constraint may be an important factor to consider in the evaluation of death causation for blunt force impacts to the pediatric skull. Abstract published by arrangement with John Wiley & Sons.