PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “fall from height”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMed1990

The postnatal development of the air-righting reaction in albino rats. Quantitative analysis of normal development and the effect of preventing neck-torso and torso-pelvis rotations.

The aim of this study was to describe the ontogenesis of the air-righting reaction (ARR) in rats. The first experiment was performed on 6 newborn albino rats of both sexes and followed the development of the ARR over postnatal days 1-21. The degree of rotation achieved after falling from different heights was quantified according to a rating scheme. It appeared that the air-righting reaction is effected by a spiral movement which spreads in a cranio-caudal direction. The reaction develops between postnatal day 8 and 18. On postnatal day 10 only a few animals are able to turn their heads, this being possible only from a falling height of 60 cm and corresponding to a falling time of 350 ms. A rapid development of the reaction was found between days 10 and 14. The second experiment on 8 rats involved the use of immobilization in order to isolate the mechanisms that trigger the ARR. The immobilization prevented neck-torso rotation, torso-pelvis rotation, and both rotations in different animals. Despite the disruption of important (afferent) feedback systems, the reaction developed within the same age period as in control rats. Thus, the Magnus "chain reflex hypothesis' as basis for the ARR is rejected in favor of a central motor program hypothesis.

Age Factors↗
PubMed2004

Effects of lumbar extensor fatigue and fatigue rate on postural sway.

Falls from heights resulting from a loss of balance are a major concern in the occupational setting. Previous studies have documented a deleterious effect of lower extremity fatigue on balance. The purpose of this study was to investigate the effect of lumbar extensor fatigue on balance during quiet standing. Additionally, the effects of fatigue rate on balance and balance recovery rate were assessed. Eight center-of-pressure-based measures of postural sway were collected from 13 participants, both before and after a protocol that fatigued the lumbar extensors to 60% of their unfatigued maximum voluntary exertion force. In addition, postural sway was measured for 30 min after the fatiguing protocol, at 5-min intervals, to quantify balance recovery rate during recovery from fatigue. Two different fatigue rates were achieved by fatiguing participants over either 10 min or 90 min. Results show an increase up to 58% in time-domain postural sway measures with lumbar extensor fatigue, but no change in frequency-domain measures. Fatigue rate did not affect the magnitude of these postural sway increases, nor did it affect the rate of balance recovery following fatigue. Statistical power for the latter result, however, was low. These results show that lumbar extensor fatigue increases postural sway and may contribute to fall-from-height accidents.

Adult↗
PubMed2003

The use of a dynamic condylar screw and biological reduction techniques for subtrochanteric femur fracture.

A study was designed to examine the outcomes of patients with closed comminuted subtrochanteric femoral fractures fixed with a dynamic condylar screw (DCS) and using biological (indirect) reduction techniques at a tertiary referral centre.Thirty-one consecutive patients with a mean age of 32.6 years, who sustained subtrochanteric femoral fractures, were treated with this method. Twenty-seven cases (87.2%) sustained these fractures either from traffic crashes or falls from height and the remaining four had a simple fall. Average follow-up was 3 years (range 14-65 months). Patients were assessed clinically and radiographically with regards to fracture classification, operating time, blood loss, time of union, malunion and other complications. Union was achieved in all cases (100%), with full-weight bearing after an average of 4.9 months. The average operating time was 2h and blood loss averaged 430 ml. There was only one case of superficial infection, which settled with local debridement and antibiotics. Malunion was seen in 2 cases out of 31 (6.4%) without the need for further surgery. In conclusion, use of biological (indirect) reduction techniques instead of anatomic, open reduction has proven to be successful, especially in comminuted subtrochanteric fractures. The early appearance of callus avoids the need for primary cancellous bone grafting, emphasising the importance of preserving biology of the fracture fragments.

Adolescent↗
PubMed2003

Rates of pediatric injuries by 3-month intervals for children 0 to 3 years of age.

OBJECTIVE: Mortality and morbidity data on childhood injury are used to construct developmentally appropriate intervention strategies and to guide pediatric anticipatory counseling on injury prevention topics. Effective anticipatory guidance depends on detailed injury data showing how risks change as children develop. Conventional age groupings may be too broad to show the relationship between children's development and their risk of various causes of injury. Previous studies revealed differences in overall rates and specific causes of injury by year of age. However, single year of age rates for children younger than 4 years may not reflect the variations in risk as a result of rapid developmental changes. This study was designed to analyze injury rates for children younger than 4 years by quarter-year intervals to determine more specifically the age period of highest risk for injury and for specific causes. METHODS: We used data from 1996-1998 California hospital discharges and death certificates to identify day of age and external cause of injury (E-code) for children younger than 4 years. The number of California residents for each day of age was estimated from US Census of estimates of California's population by year of age for the midpoints (1996-1998). Rates were calculated by 3-month intervals. We grouped the E-codes into major categories that would be particularly relevant for developmentally related risks of injury specific to young children. The categorization took into account physical, motor, behavioral, and cognitive developmental milestones of children 0 to 3 years. RESULTS: There were a total of 23,173 injuries; 636 resulted in death. The overall annual rate for children aged 0 to 3 years was 371/100,000. Beginning at age 3 to 5 months, the overall rate of injury rapidly increased with increased age, peaking at 15 to 17 months. The mean injury rate calculated for each single year of age did not reflect the variation and the highest rate of injury by quarter year of age for children younger than 1 year, 1 year, and 2 years. The leading major causes of injury in descending order were falls, poisoning, transportation, foreign body, and fires/burns. The overall rate of the major category of falls exceeded poisoning, the second leading cause of injury, by a factor of 2. Age-related differences were detected within each major cause of injury. For children 0 to 12 months of age, there was a different leading cause of specific injury for each 3-month period: other falls from height (0-2 months), battering (3-5 months), falls from furniture (6-8 months), and nonairway foreign body (9-11 months). Hot liquid and vapor injuries were the leading specific causes for children 12 to 17 months. Poisoning by medication was the leading specific cause of injury for all age groups from 18 to 35 months and exceeded poisoning by other substances. Pedestrian injury was the leading specific cause of injury for all age groups from 36 to 47 months. Fall from furniture has the highest rates of specific causes of falls from age 3 to 47 months. Fall from stairs peaked at age 6 to 8 months and 9 to 11 months. Fall from buildings was highest at 24 to 26 months. Poisoning by medication peaked at age 21 to 23 months, but poisoning by other substances peaked at 15 to 17 months. The motor vehicle occupant injury rates were fairly stable over the age span of this study. The pedestrian injury rate increased beginning at age 12 to 14 months and by 15 to 17 months was double that of the motor vehicle occupant. Foreign body had a marked peak at age 9 to 11 months. Both battering and neglect rates were highest among infants 0 to 2 and 3 to 5 months. Bathtub submersions had a narrow peak at age 6 to 11 months. Other submersions peaked at 12 to 14 months and remained high until 33 to 35 months. CONCLUSIONS: We departed from usual groupings of E-codes and devised groupings that would be reflective of age-related developmental characteristics. Differences in rates by narrow age groups for young children can be related to developmental achievements, w can be related to developmental achievements, which place the child at risk for specific causes of injury. We found marked variability in both rates and leading causes of injury by 3-month interval age groupings that were masked by year of age analyses. Children aged 15 to 17 months had the highest overall injury rate before age 15 years. This coincides with developmental achievements such as independent mobility, exploratory behavior, and hand-to-mouth activity. The child is able to access hazards but has not yet developed cognitive hazard awareness and avoidance skills. A remarkable finding was the high rate of battering injury among infants 0 to 5 months, suggesting the need to address potential child maltreatment in the perinatal period. Poisoning was the second major leading cause of injury; more than two thirds were medication. Cultural factors may influence views of medications, storage practices, use of poison control system telephone advice, and risk of toddler poisoning. The pedestrian injury rate doubled between 12 and 14 months and 15 and 17 months and exceeded motor vehicle occupant injury rates for each 3-month interval from 15 to 47 months. Pedestrian injury has not received sufficient attention in general and certainly not in injury prevention counseling for children younger than 4 years. Anticipatory guidance for pedestrian injury should be incorporated before 1 year of age. Effective strategies must be based on the epidemiology of childhood injury. Pediatricians and other pediatric health care providers are in a unique position to render injury prevention services to their patients. Integrating injury prevention messages in the context of developmental assessments of the child is 1 strategy. These data can also be used for complementary childhood injury prevention strategies such as early intervention programs for high-risk families for child abuse and neglect, media and advocacy campaigns, public policies, and environmental and product design.

Accidental Falls↗
PubMed2005

Accidental head injuries in children under 5 years of age.

AIM: To evaluate the type and nature of head injuries sustained by children under the age of 5 years who present to a busy accident and emergency (A&E) department following an accidental fall. MATERIALS AND METHODS: This study included all children under the age of 5 years, who over an 8-month period were referred to our A&E Department with head injury following an accidental fall. Data were collected regarding the height of the fall, whether or not stairs were involved, the type of surface that the child landed on and the height of the child. This was correlated with any soft-tissue injury or skull fracture. RESULTS: A total of 72 children (aged 4 months to 4.75 years) fulfilled all the criteria for an accidental fall. The heights of the falls ranged from less than 50 cm to over 3 m, with the majority below 1 m. Of the falls, 49 were onto a hard surface and 23 were onto a soft surface. Of the 72 children, 52 had visible evidence of head injury, 35 (71%) of 49 being the result of falls onto hard surfaces and 17 (74%) of 23 onto soft (carpeted) surfaces. There was no significant difference in the type of surface that resulted in a visible head injury. A visible head injury was seen in all children who fell from a height of over 1.5 m and in 95% of children who fell over 1 m. Of the 72 children, 32 (44%) had skull radiographs performed in accordance with established guidelines and 4 (12.5%) were identified as having a fracture. Of the 3 linear parietal fractures 2 were inflicted by falls of just over 1 m (from a work surface) and 1 by a fall of 80 to 90 cm onto the hard-edged surface of a stone fire surround. The 4th was a fracture of the base of skull following a fall from more than 3 m (from a first-storey window). CONCLUSIONS: In the vast majority of domestic accidents children do not suffer significant harm. Skull fractures are rare and probably occur in less than 5% of cases. To cause a skull fracture the fall needs to be from over 1 m or, if from a lesser height, then a small-area impact point should be considered an integral component of the injury.

Accidental Falls↗
PubMed2004

The influence of behavior on freefall injury patterns: possible implications for forensic anthropological investigations.

Case studies of freefall injuries suggest that most falls from heights result in lower extremity, pelvic, and vertebral fractures. These injuries are largely a consequence of the fact that most falls are accidental with victims landing feet first. This study investigates whether human behavioral response affects body orientation at impact and whether the human body tends to align in a particular way as a result of physical laws. The investigation was undertaken by observing nine experimental falls of an anthropomorphic dummy from a height of 65 ft (9.8 m). In all nine falls, the dummy landed horizontally, suggesting that the human form has a tendency to align horizontally during freefall for falls greater than 50 ft (15.24 m). This has important implications for the potential use of injury patterns in the deduction of pre-fall circumstances, which are discussed here with respect to a case study of a fall victim.

Accidental Falls↗
PubMed2006

[Comparison of various kinds of internal fixations in unstable intertrochanteric femoral fracture].

OBJECTIVE: To explore the effects of various kinds of internal fixations on unstable intertrochanteric femoral fractures. METHODS: From January 2000 to December 2004, 88 cases of unstable intertrochanteric femoral fractures were treated. There were 52 males and 36 females (aged 19-86 years). Twenty-two cases were caused by fall from height, 36 by motor vehicle accident and 20 by fall and 10 by tumble. They were divided into 4 groups according to 4 kinds of internal fixations: dynamic hip screw (DHS, group A, n=42), anatomical proximal femur bone plate (group B, n = 23), proximal femoral nail (PFN, group C, n = 8)and dynamic condylar screw (DCS, group D, n = 15). According to the modified Evan's classification, fractures were all unstable type and were classified as follow types: group A (15 type III, 8 type IV and 19 type V); group B (12 type III, 5 type IV and 6 type V); group C (3 type III, 2 type IV and 3 type V); and group D (10 type III, 3 type IV and 2 type V). The data of operative time, intra-operative blood loss, intra-operative complications, fluoroscopy exposures, clinical healing time of fracture, post-operative restored function and postoperative complications were recorded and analyzed statistically using the SPSS 12.0 software package. RESULTS: All patients were followed up for 12-48 month (18 months on average). All patients achieved clinical healing. Coxa varus occurred in 3 cases of group A, in 1 case of group C and in 3 cases of group D. The differences were of no statistical significance in operative time and postoperative complications between 4 groups (P>0.05). The difference was of statistical significance in the blood loss between groups A, B and groups C, D (P<0.05) but no statistical significance between group C and group D (P>0.05). The difference was of statistical significance in the fluoroscopy exposures, clinical healing time of fracture and postoperative complications between group B and the other groups (P<0.05). The difference was of statistical significance in the post-operative restored functions between group D and the other groups (P<0.05). CONCLUSION: The anatomical proximal femur bone plate is a useful device in the treatment of unstable intertrochanteric femoral fracture. The operative manipulation is simple and the hip functions recover well.

Adult↗
PubMed2006

Pre-landing muscle timing and post-landing effects of falling with continuous vision and in blindfold conditions.

The present study examined the effect of continuous vision and its occlusion in timing of pre-landing actions during free falls. When vision is occluded, muscle activation is hypothesized to start relative to onset of the fall. However, when continuous vision is available onset of action is hypothesized to be relative to the moment of touchdown. Six subjects performed 6 randomized sets of 6 trials after becoming familiar with the task. The 36 trials were divided in 2 visual conditions (vision and blindfold) and 3 heights of fall (15, 45 and 75 cm). EMG activity was recorded from the gastrocnemius and rectus femoris muscles during the falls. The latency of onset (L(o)) and the lapse from EMG onset to touchdown (T(c)) were obtained from these muscles. Vertical forces were recorded to assess the effects of pre-landing activity on the impacts at collision with and without continuous vision. Peak amplitude (F(max)), time to peak (T(max)) and peak impulse normalized to momentum (I(norm)) were used as outcome measures. Within flight time ranges of approximately 50-400 ms, the results showed that L(o) and T(c) follow a similar linear trend whether continuous vision was available or occluded. However, the variability of T(c) for each of the muscles was larger in the vision occluded condition. Analyses of variance showed that the rectus femoris muscle started consistently earlier in no vision trials. Finally, impact forces were not different in vision or blindfold conditions, and thus, they were not affected by minor differences in the timing of muscles prior to landing. Thus, it appears that knowing the surroundings before falling may help to reduce the need for a continuous visual input. The relevance of such input cannot be ruled out for falls from high landing heights, but cognitive factors (e.g., attention to specific cues and anticipation of a fall) may play a dominant role in timing actions during short duration falls encountered daily.

Adult↗
PubMed2001

Compliance of Dunedin school playground equipment with the New Zealand playground standard.

OBJECTIVE: Injuries resulting from falls from playground equipment are a public health concern in New Zealand. Like many other countries, New Zealand has a safety standard aimed at reducing the incidence and severity of these injuries by limiting the height from which children can fall from playground equipment and requiring the provision of impact-absorbing surfaces beneath equipment from which falls are possible. The purpose of this study was to examine progress towards achieving compliance with these requirements in Dunedin school playgrounds. METHODS: Sixty-two schools were audited over the summer of 1997/98 and information recorded on equipment type, maximum fall height, surface type, and depth of loose-fill surface materials. Comparisons were made with audits conducted in 1989 and 1981. RESULTS: Substantial increases in the amount of playground equipment and in the provision of impact-absorbing surfaces were observed. A small increase in compliance with the requirement that the maximum fall height of equipment not exceed 2.5 metres was also observed. CONCLUSIONS: Any gains in safety achieved through increased compliance with the height and surface requirements of the New Zealand Standard have been counteracted by the substantial increase in the amount of equipment available in playgrounds. IMPLICATIONS: A more drastic measure is needed to achieve a meaningful reduction in the incidence of injury following falls from playground equipment.

Accidental Falls↗
PubMed2002

[Palmar lunate dislocation].

UNLABELLED: Palmar lunate dislocation as the end stage of a perilunate dislocation is a very uncommon injury. Having treated 19,534 hospitalized patients between 1 January 1986 and 1 October 2001 the diagnosis was recorded in four male trauma patients (33, 36, 37 and 62 years old). Among the operatively treated carpal dislocations and carpal fracture dislocations those of the lunate were seen in five per cent. The dislocation was caused in by an acute hyperextension injury resulting of falls from heights in three cases, and of a motorcycle accident in a further case. In two of these cases a complete palmar lunate dislocation was analysed that were produced by fall from seven meters heights of a young craftsman and by accident of a motorcyclist. First using a longitudinal palmar approach in both cases a revision of the hemorrhagic carpal canal was performed urgently, the largely denuded lunate was reduced and the repair of identified ligamentous structures was performed by means of sutures respectively suture anchors. Reduction was stabilized with Kirschner wires. Afterwards performed computed tomography identified the result of reduction and associated defects (subluxation distal radioulnar joint). In one patient a soft tissue infection prevented the dorsal ligamentous repair. In spite of a consequent after-treatment and a good functional result a scapho-lunate dissociation was proved. An avascular defect of the lunate could be excluded by magnetic resonance imaging. In case of a secondary performed dorsal repair a persisting carpal stabilization with a satisfactory functional result could achieved. At second hand an advanced carpal collapse was proved. CONCLUSIONS: If reduction cannot be achieved by closed manipulation or a loss of reduction is shown, open reduction is indicated first by a palmar approach. An additional dorsal ligamentous repair seems to be necessary. Transfixation by Kirschner wires and suture anchors stabilize the restored anatomic relationships. Wrist immobilization in a cast for at least eight weeks is recommended. Although ligamentous insufficiency, osteoarthrosis and avascular necrosis are often proved, functional results are satisfactory.

Adult↗
PubMed2007

Ladders revisited.

OBJECTIVE: To describe the epidemiology of falls from ladders in a state-wide population. DESIGN AND SETTING: Retrospective review of data from the the Victorian State Trauma Registry and the Victorian Emergency Minimum Dataset on patients presenting to public hospital emergency departments (EDs) with injuries due to a fall while climbing a ladder, from 1 July 2001 to 30 June 2005. MAIN OUTCOME MEASURES: Overall trends in the incidence of ladder-related ED presentations, and in cases of major trauma, trends according to age, and trends according to activity at the time of the fall. RESULTS: 4553 patients presented to EDs after falls from ladders in Victoria during the study period; 160 patients had injuries classified as major trauma. There has been a significant rise in the number of presentations to EDs following falls from ladders in Victoria, with a marked increase in the number of cases involving patients aged over 50 years and those climbing ladders outside of paid working conditions. Deaths occurred predominantly in the elderly after falls from heights above 1 metre. CONCLUSIONS: Despite knowledge of the dangers of falls from ladders, there has been a significant increase in the number of patients presenting to hospitals after ladder falls. Middle-aged to elderly patients undertaking unpaid work account for this increase. A targeted public health initiative is required to curb this trend.

Accidental Falls↗
PubMed1999

Role of computed tomography in spinal trauma.

Twenty patients admitted for spinal trauma were studied with computed tomography (CT) scan. All the patients had initial routine plain radiographs in the anteroposterior and lateral views. Ten patients sustained injury due to fall from height, 7 suffered road side accident, 2 had injury due to fall of weight on back and one suffered due to slip on floor. Twelve patients had injury at multiple levels. Twenty-four vertebral bodies were involved in 20 patients, 10 had fracture of posterior elements only. Neurological deficit occurred in 16 patients. CT scan provided more information than plain radiography, which missed vertebral body fracture in 2 out of 24 instances and spinal canal compromise in 7 out of 12 patients. CT scan detected posterior element injuries better and in greater detail in all cases.

Adolescent↗
PubMed1997

Single rope tree swing injuries among children.

OBJECTIVE: To examine the scope and severity of injuries sustained from falls from single rope tree swings among children. METHODS: Twenty-six children formed the basis of this retrospective study. Patients were divided into three groups based on the estimated distance of their fall (one, two, or three stories). Data were analyzed with respect to mechanism of injury, age, gender, length of hospital stay, injury severity score, number and type of injuries, and mortality. RESULTS: Eighteen patients fell from ropes, and 8 from vines (all onto packed dirt). Fourteen falls occurred from one story or less, 8 from two stories, and 4 from three stories. One death occurred from intracranial injury following a two-story fall. No difference in age, gender, injury severity score, or length of hospital stay with respect to the height of the fall was observed. Falls from lower heights resulted in equally severe injuries as falls from higher heights. Overall, head trauma was the most common injury (58%) followed by long bone fractures (42%), axial skeletal fractures (23%), and intra-abdominal visceral injuries (8%). CONCLUSIONS: The present study demonstrated that recreational single rope tree swing injuries among children resulted in significant morbidity regardless of the height of the fall. This activity carries a substantial risk for serious injury. The mechanism of injury, clinical data, and the importance of medical awareness and patient education are emphasized.

Abdominal Injuries↗
PubMed1999

The strengths and limitations of parental heights as a predictor of attained height.

Mid-parental heights are widely used to help assess an individual child's growth. However, the methods in use vary, and most make no allowance for extremes of parental height. This study aimed to examine the actual distribution of parental heights in a survey population and the relation with their children's heights. The heights of 419 representatively sampled children aged 8-9 years were compared with their reported mid-parental heights, all expressed as standard deviation scores (SDS). These confirmed previous predictions that 90% of the children's heights would fall within 1.5 SDS (approximately two centile spaces) of their mid-parental heights. However, where parents were unusually tall or short, their children were relatively less tall or short, respectively, and the mid-parental height was a poor predictor of attained height. A simple calculator for expected height centile is described that automatically adjusts for this regression to the mean. Of 13 children below the second centile for height, eight were within two centile spaces (90% range) of their mid-parental height SDS. However, when allowance was made for regression to the mean, only three of 13 were within the 90% range. Although mid-parental height provides a useful guide to expected height centile for children and parents of average stature, it can be misleading when used to assess short children.

Body Height↗