Hahn M P, Richter D, Ostermann P A, Muhr G
Chirurgische Universitätsklinik und Poliklinik, Berufsgenossenschaftliche Kliniken, Bergmannsheil, Bochum.
Unfallchirurg. 1995 Dec;98(12):609-13.
There are few references discussing the typical injury patterns of adults after a fall from a height. We present the pattern of injury in 101 adult patients who were treated between 1987 and 1990 at our trauma center after falling from an average height of 7.2 m. In 62 patients the fall was accidental; 39 patients tried to commit suicide by jumping from a height. The most common injuries were fractures of the thoracic and lumbar spine (83.0%) with a preference for the thoracolumbar junction. Fracture of the lower limbs occurred in 45%. The most frequent injuries were fractures of the os calcis (64.4%) and the ankle joint (26.6%). Twenty-five percent of all patients suffered from fractures in the upper limbs with a preference for the distal radius (56.6%) and the elbow (44.0%). There were no differences between the injury patterns after a fall from a height of more than 7 m or less than 7 m. The incidence of thoracic and pelvic injuries (30.0%) increased after falls from more than 7 m. The neurological complications of injuries to the spine corresponded to increasing height. According to our analysis blunt abdominal trauma is an uncommon injury after falling from a great height. Head injuries, which would be expected to be the most common cause of death in all non-survivors in the literature, only occurred in 27% of our patients who all survived their transport to hospital.
关于成人高处坠落伤典型损伤模式的参考文献较少。我们呈现了1987年至1990年间在我们创伤中心接受治疗的101例成人患者的损伤模式,这些患者平均从7.2米高处坠落。其中62例患者为意外坠落;39例患者从高处跳下试图自杀。最常见的损伤是胸腰椎骨折(83.0%),以胸腰段交界处为主。下肢骨折发生率为45%。最常见的骨折是跟骨骨折(64.4%)和踝关节骨折(26.6%)。所有患者中有25%上肢骨折,以桡骨远端骨折(56.6%)和肘部骨折(44.0%)为主。7米以上或以下高处坠落的损伤模式无差异。从7米以上高处坠落时,胸部和骨盆损伤的发生率(30.0%)增加。脊柱损伤的神经并发症与坠落高度增加相关。根据我们的分析,钝性腹部创伤在高处坠落伤中并不常见。文献中预期所有非幸存者最常见的死亡原因——头部损伤,仅发生在我们27%的患者中,且这些患者均在转运至医院后存活。