Orthopaedic and traumatology, Dicle University Medicine Faculty, Diyarbakir, Turkey.
Department of Orthopedics and Traumatology, Medicana International Hospital, Istanbul, Turkey.
Med Sci Monit. 2024 Jan 16;30:e942831. doi: 10.12659/MSM.942831.
BACKGROUND Suicide attempts that involve jumping from a great height may not be fatal but can result in lumbosacral facture-dislocations. This retrospective study aimed to present the experience from a single center in Turkey of 21 patients with lumbosacral facture-dislocations, or suicidal jumper fractures, treated with lumbosacral fixation between 2015 and 2022. MATERIAL AND METHODS The study included 21 patients. The diagnosis was established through X-ray and computed tomography (CT) examinations. Neurological damage was assessed using the Gibbons score. Among the patients, 2 were classified as Roy-Camille type 1, 12 as Roy-Camille type 2, and 7 as Roy-Camille type 3. Morphologically, 8 patients had H-type fractures, 7 had T-type fractures, and 6 had U-type fractures. Bilateral spinopelvic fixation was performed. Functional outcomes were evaluated using the Majeed score. RESULTS The average Injury Severity Score (ISS) was 31.6±12.2. The mean duration of surgery was 123.6±44.9 minutes. According to the Majeed score, excellent results were observed in 8 individuals (40%), good results in 5 individuals (25%), fair results in 5 individuals (25%), and poor results in 2 individuals (10%). Out of 18 patients with neurological deficits, 14 showed improvement after surgery, while 4 continued to experience deficits. CONCLUSIONS The findings from this study highlight the importance of obtaining a clear history of the cause of lumbosacral facture-dislocation, as attempted suicide by jumping from a height can cause specific types of injury to the lumbar spine and sacrum that require rapid diagnosis and management to reduce the incidence of permanent paraplegia.
涉及从高处跳下的自杀未遂事件可能不会致命,但可能导致腰骶部骨折脱位。本回顾性研究旨在展示土耳其一家中心在 2015 年至 2022 年间采用腰骶固定治疗 21 例腰骶部骨折脱位或自杀跳楼者骨折患者的经验。
该研究纳入 21 例患者。通过 X 射线和计算机断层扫描(CT)检查确诊。采用 Gibbons 评分评估神经损伤情况。患者中,2 例为 Roy-Camille 1 型,12 例为 Roy-Camille 2 型,7 例为 Roy-Camille 3 型。形态学上,8 例为 H 型骨折,7 例为 T 型骨折,6 例为 U 型骨折。行双侧脊柱骨盆固定。采用 Majeed 评分评估功能结果。
平均损伤严重度评分(ISS)为 31.6±12.2。手术平均时间为 123.6±44.9 分钟。根据 Majeed 评分,8 例(40%)为优,5 例(25%)为良,5 例(25%)为可,2 例(10%)为差。18 例有神经功能缺损的患者中,14 例术后改善,4 例继续存在神经功能缺损。
本研究结果强调了明确腰骶部骨折脱位病因病史的重要性,因高处跳下自杀可能导致腰椎和骶骨特定类型的损伤,需要快速诊断和处理,以降低永久性截瘫的发生率。