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 307 records · Page 17Linked to original sources

PubMed2005

Rehabilitation outcomes following traumatic spinal cord injury in a tertiary spinal cord injury centre: a comparison with an international standard.

STUDY DESIGN: Retrospective descriptive analysis of data of patients with traumatic spinal cord injury (SCI) in a tertiary SCI centre. OBJECTIVES: To identify the characteristics of the rehabilitation outcomes of patients with different levels of traumatic SCI and to compare the results with data reported in the American Consortium for Spinal Cord Medicine. SETTING: A newly established tertiary SCI centre in Tai Po Hospital, Tai Po, Hong Kong. METHODS: A total of 33 patients with traumatic SCI admitted in 2002 were included in the study. They were classified into different ASIA subgroups based on their levels and completeness of injury. The functional status changes measured by the Functional Independence Measure (FIM) (on admission, placement and upon discharge, and at 1 and 3 months post discharge) and discharge placement were recorded as rehabilitation outcomes. RESULTS: A total, 24 patients were tetraplegic while nine were paraplegic. Seven and two from tetraplegic and paraplegic groups were readmitted with late complications due to urinary tract infection, spasticity and/or occurrence of pressure sores. The mean age was found to be 48.36 (SD=15.64) years. In all, 16 (48.48%) sustained the injury from falling from height. The trend of FIM motor scores at discharge across different ASIA subgroups appeared to be comparable to those reported in the American Consortium for Spinal Cord Medicine with scores generally lower. Significant functional improvements during the hospital phase were found in the two tetraplegic and paraplegic ASIA D subgroups (t3=3.430, P<0.05; t2=4.083, P=0.55, respectively). Significant differences were also revealed among subgroups (F(7,32)=6.625, P<0.0005) with lower level tetraplegic groups appearing to stay much longer in the rehabilitation centre. In all, 64.5% of newly diagnosed patients returned to live in the community. CONCLUSIONS: This report gives a preliminary overview on the characteristics of rehabilitation outcomes in one of the SCI centres in Hong Kong in relation to the international standard. Longitudinal study with larger population and community integration outcomes might be included in the future to reveal a better picture in the SCI rehabilitation in Hong Kong.

Adult↗

PubMed1973

Shapes of curves of pH-dependence of reactions.

A simple case is considered in which the rate of a two-step reaction depends on pH because the intermediate formed in the first step has to gain (or lose) a proton before it can react in the second step, and in which the rate-determining step therefore changes with pH. The curves of reaction rate against pH are shown to be symmetrical, and the sharpest peak possible has a width at half its height of 1.53pH units, i.e. of 2log(3+2 radical2). Any particular curve for this situation proves to be identical with a curve that could be generated for the pH-dependence of a single-step reaction in which the rate is proportional to the concentration of a particular ionic form of a reactant. Curves for the latter situation, however, can have forms impossible for the former case in which the rate-determining step changes, but only if the protonations that activate and deactivate the reactant are co-operative. The peak can then become even sharper, and its width at half its height can fall to 1.14pH units, i.e. to 2log(2+ radical3).

Chemical Phenomena↗

PubMed2002

Neuropathological investigation of cerebral white matter lesions caused by closed head injury.

In order to ascertain whether there is widespread axonal disruption of cerebral white matter in the so-called 'diffuse axonal injury' (DAI), a type of closed head injury, proposed by Adams et al. the author investigated his own cases clinicopathologically. Twenty-six male autopsied cases of head injury, aged between 19 and 84, 15 of which had sustained road traffic accidents, were examined; the others were due to falling from heights and so on. The study group all belonged to non-missile head injuries and included 12 cases of diffuse brain injury, as well as 14 cases of focal brain injury, according to the classification of Gennarelli et al. The survival time ranged from 2 h to 21 years. Formalin-fixed brains were cut coronally so as to make paraffin-embedded hemispheric sections. Then these sections were stained conventionally (HE, Bodian, Kluver-Barrera and Holzer) and immunohistochemically (GFAP) to assess axonal decrease, myelin pallor and gliosis by the use of light microscopy. In the 13 chronic cases that died more than 1 month after the accidents, the intensities of gliosis, myelin pallor and axonal decrease tended to correlate with each other. In the 13 acute cases who died less than 1 month after their accident, the degree of axonal decrease in white matter seemed to correlate with the severity of myelin pallor. Regardless of types of trauma, however, axonal retraction balls, the so-called hallmark of DAI, were found only with myelin pallor suggesting the presence of brain swelling after the injury. Therefore these findings indicate that it may be difficult to accept the notion of DAI, that is, the presence of axonal retraction balls without brain swelling. In addition, diffuse vascular injury (2 cases) as well as rarefaction of subcortical white matter (6 cases) were presented and their pathogenesis individually discussed based on a literature review.

Adult↗

PubMed2006

Acute traumatic aortic tear: open versus stent-graft repair.

Acute traumatic aortic tear (ATAT) is the second most common cause of deaths in trauma patients (about 8,000 deaths/year in the USA). Due to circumferential aortic disruption, up to 90% die at the scene. Responsible trauma mechanisms are: penetrating (gunshot/stab wounds), iatrogenic (interventional catheterization) and, most frequently, blunt chest trauma (high-speed motor vehicles, falls from heights, crushes, explosions) resulting in injury at the aortic isthmus region (loco typico, about 90%). Severe multiple system injuries (polytrauma), especially to intracranial and intraabdominal organs, are characteristic and prognostically predicitive. Immediate transthoracic open repair of ATAT has a mortality risk of 8% to 33% and paraplegia risk of 2% to 26%. Contrast enhanced CT scan has replaced the classical angiography as the diagnostic tool of choice. Patients with life-threatening multisystem injuries are scheduled for delayed repair after initial stabilization. Currently, the use of endovascular stent-grafts (EVAR) is being investigated. Our personal series confirms that EVAR for ATAT is a viable alternative to open repair while minimizing the morbidity and mortality of the open procedure and having a limited impact on trauma destabilization. The assessment of long-term durability of EVAR is one of the key issues to consider EVAR as the first choice of treatment.

Algorithms↗

PubMed2005

Traumatic rupture of the aorta in adolescence--description of two cases.

Aortic disruption is a well documented cause of death in motor vehicle accidents and falls from heights. These injuries also affect children. About 10 % who survive despite aortic injury could potentially be saved provided the diagnosis is established and surgical intervention is undertaken early enough. We present here 2 cases of adolescents aged 17 years, treated in our hospitals with different results. In the first case, timely diagnosis of aortic pseudoaneurysm could not be made, which resulted in its rupture and the death of the patient. In the other patient an early diagnosis of aortic injury was established already in the Emergency Department. The patient was then transferred for further surgical treatment which proved successful. Diagnosis of traumatic aortic rupture is impossible at the accident site and can also be missed in hospital. The symptoms of aortic rupture are not characteristic. The knowledge of the mechanism of injury is extremely important. The diagnosis is established based on chest X-ray, computed tomography, and transoesophageal echocardiography. In cases of doubt, aortography remains decisive in the identification of an aortic injury.

Accidents, Traffic↗

PubMed2002

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system.

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.

Accidents, Occupational↗

PubMed1987

Diffuse axonal injury by assault.

A case of diffuse axonal injury (DAI) by assault is reported. The majority of DAI cases documented have been due to traffic accidents and some due to falls from height. DAI is caused by angular or rotational acceleration of the victim's head. The condition is common and is the second most important head injury after subdural hematoma with regard to death. Its clinical picture is characterized by immediate and prolonged coma or demented state. Because of the subtle nature of histological changes in DAI, awareness and intentional search for the lesion is essential. The triad of DAI is as follows: focal lesions (hemorrhages and/or lacerations) in the corpus callosum and brain stem, and microscopic demonstration of axonal damage--retraction balls. The concept of DAI will elucidate and enhance the understanding of many head trauma cases.

Adult↗

PubMed2001

Elderly suicide: a 10-year retrospective study.

The suicide rate in the 65-year and older age group has been increasing since 1980. The elderly attempt suicide less often than younger people but are successful more often. The authors retrospectively reviewed all cases referred to the Forensic Pathology Section of the Medical Examiners' Office at the Medical University of South Carolina (Charleston, SC) from January 1988 through December 1997. The cases of suicide in victims 65 years and older totaled 78, accounting for 11.5% of all suicides reviewed. Of these 78 cases, 41% were autopsied and 59% were externally examined. All of the cases were initially analyzed as to age, race, sex, and method of suicide. Files also were reviewed to determine time of year of the suicide, toxicology results, psychiatric history, social history, medical history, and whether a suicide note was left. The ages of these suicide victims ranged from 65 to 94 years; men comprised 85% of the victims, and whites, 94%. The male-to-female and white-to-black ratios were 6:1 and 15: 1, respectively. The average age of the victim was 73 years. Gunshot wound was the most common method of suicide, accounting for 80.7% of the cases. Other methods included overdose (6.4%), hanging (3.8%), fall from height (2.6%), incised wounds (2.6%), drowning (2.6%), and carbon monoxide poisoning (1.3%).

Aged↗

PubMed1993

Epidemiology and risk factors of osteoporosis.

Recent osteoporosis research has been oriented increasingly toward understanding the determinants of peak bone mass acquisition during childhood and adolescence. Genetic factors may account for approximately half of the variability in peak femoral bone mass density, and racial differences in bone mass have been shown to appear early in life. Physical activity appears to play an important role in increasing bone mass during childhood. Most fractures in the elderly have been found to be associated with reduced bone mass and could therefore be considered osteoporotic. Retrospective reviews of medical records from residents of Rochester, Minnesota, suggest that approximately one third of women with vertebral deformities seek medical attention. Other cross-sectional data suggest that vertebral deformities cause substantial back pain and disability only if vertebral height ratios fall 4 SD below the mean.

Aging↗

PubMed2004

Open subtalar dislocation treated by distractional external fixation.

Subtalar dislocation is a rare injury, constituting approximately 1% of acute dislocations, and often is the result of high-energy trauma, particularly falls from heights. We present a case of a 33-year-old man who sustained a Gustilo type IIIB open subtalar dislocation when he fell 4 m from a scaffold. After irrigation and debridement, a Mitkovic distractional external fixator was applied medially for 6 weeks while the wound healed by secondary intention. Physical therapy was initiated along with partial to full weight bearing during the next 3 months. The patient returned to work at 8 months postinjury. At 24 months, the patient had a normal gait with pain only during prolonged periods of standing or walking. X-rays and MRI were normal with no signs of avascular necrosis or posttraumatic arthritis. Ankle joint range of motion was dorsiflexion 5 degrees and plantar flexion 45 degrees with moderately limited subtalar joint motion. The distractional external fixator allowed for complete wound care and unburdening of the talus, which perhaps reduced the possibility of avascular necrosis.

Adult↗

PubMed1984

Fractures of the talus.

A total of 35 patients treated in the years 1970 to 1977 for fractures of the talus were investigated for an analysis of the long-term clinical end results. Falling from height was the most common cause of injury (15 patients), the next most common being road traffic accidents (13 patients). The mean followup time was 8 years. At followup, 19 patients were free of any discomfort and none had pain at rest. The incidence of pain was correlated significantly (p less than 0.01) with the grade of dislocation both before and after reduction. In severely dislocated fractures open reduction and osteosynthesis with a compression screw are recommended.

Adult↗

PubMed1988

Variables affecting outcome in blunt chest trauma: flail chest vs. pulmonary contusion.

We reviewed 144 consecutive patients with flail chest and/or pulmonary contusion between 1979 and 1984. The purpose was to analyze the factors adversely affecting morbidity and mortality. There were 97 males and 47 females, with an average age of 40 years +/- 18 S.D. (range, 2-83). Seventy-five per cent of the injuries were caused by motor vehicle accidents, with the remainder due to falls (17%), cardiopulmonary resuscitation (4%), altercations (2%), or falling objects (2%). The Injury Severity Score (ISS) averaged 32 +/- 14 S.D. in all survivors versus 60 +/- 14 S.D. in those who died. Eighty-three patients (58%) required mechanical ventilation. Thirty-six patients died (25%). Isolated pulmonary contusion or flail chest had a mortality of 16% each. However, the mortality more than doubled when there was a combined pulmonary contusion and flail chest (42%). More than half of all deaths were directly attributed to central nervous system injuries with another third due to massive hemorrhage. Factors that were associated with a higher morbidity and mortality included severe associated thoracic injuries, a high ISS, the presence of shock, falls from heights, and the combination of pulmonary contusion and flail chest.

Adolescent↗

PubMed1989

Outcome of acetabular fractures: a 7-year follow-up.

A 10-year series of 75 acetabular fractures has been reviewed. Traffic accidents (61%) and falls from heights (20%) were the most common etiologic factors. In 80% of the patients multiple injuries were recorded. Seventeen patients were treated operatively. Forty-three patients were examined clinically and radiologically at an average of 7 years after the accident. The outcome of posterior wall fractures was usually good. Most of the fair and poor results occurred in the group of transverse fractures, in which conservative treatment did not accurately align the fracture dislocation. Operative treatment is suggested in both-column fractures and severely dislocated transverse fractures.

Acetabulum↗

PubMed1989

Fractures of the body of the tarsal navicular bone: case reports and literature review.

Four patients sustaining tarsal navicular body fractures are presented. Analysis based on these cases and on 36 patients suffering from identical fractures reported in the literature led to a new mechanical assumption: the axial compression on the foot, as a result of falling from height, causes impaction of the talus into the body of the navicular bone. The clinical followup results reported are usually disappointing. Favorable results are obtained in a vertical two-part fracture, by an open reduction and internal fixation of the tarsal navicular body fracture. In highly comminuted fractures, talo-navicular-cuneiform arthrodesis can be carried out.

Adolescent↗

PubMed1996

Two-level burst fractures: clinical evaluation and treatment options.

Two-level burst fractures are rare. In a series of 180 surgically treated spinal fracture-dislocations, seven had such injuries, with an incidence of 3.9%. Four had fracture sites without contiguity: C4-T12 (one), L1-L4 (one), L2-L4 (one), and L2-L5 (one); and three with contiguity: T12-L1 (one), L1-L2 (one), and L2-L3 (one). L2 was the most frequently involved site, accounting for four in seven. Falling from height was the most common mechanism of injury, accounting for four in seven. Five in seven patients (71%) sustained multiple injuries. Chest traumas and extremity fractures were the ones most frequently associated. All of these patients had incomplete neurologic deficits at initial presentation. In the four discontiguous bursts, the neurologic levels corresponded to the cephalic ones. Six patients had follow-up periods of more than 2 years. Transpediculate systems were used in five, and at follow-up, two had screw breakages. In this series, the average neurologic recovery was 1.3 grades on the Frankel scale. In conclusion, it is mandatory to have a thorough organ system review when such patients are first seen. Then each fracture site would be judged seperately as either a stable or unstable burst preoperatively. Every effort should be made to treat any unstable segment via anterior, posterior, or combined approaches.

Adolescent↗

PubMed1997

Bilateral craniotomies for blunt head trauma.

Development of delayed or recurrent intracranial hematomas requiring reexploration or a secondary craniotomy is well known. Patients with bilateral pathology requiring bilateral craniotomies as the initial emergency operative intervention, however, are uncommon. The lack of available literature and the large volume of head trauma seen at our institution prompted us to analyze the retrospective data on blunt head injury requiring bilateral craniotomies. Twenty patients underwent bilateral craniotomies at the University of Miami/Jackson Memorial Medical Center between January 1986 and June 1994. Ages ranged from 18 to 85 years. Mechanism of injury included motor vehicle crash (n = 4), pedestrian hit by automobile (n = 4), assault (n = 8), fall from height (n = 3), and unknown (n = 1). Epidural hematomas, acute subdural hematomas, contusions, and intracerebral hematomas were seen in varying combinations. The preoperative Glasgow Coma Scale (GCS) score ranged from 4 to 14, with a mean of 8.8 (+/-0.82 SE). Sixteen of the 20 patients survived and were discharged from the hospital. The survivors' Rancho Los Amigos Scale score on discharge ranged from 2 to 8, with a mean of 6.1 (+/-0.45 SE). A Fisher's exact test was performed to compare the outcome between the patients with mild (GCS score 13-15) to moderate (GCS score 9-12) head injury and those with severe (GCS score 4-8) head injury. It showed a statistically higher frequency of death in the severe category (p < 0.05). In conclusion, the outcome of patients with bilateral pathology requiring emergency bilateral craniotomy at initial treatment correlated well with their GCS scores at initial presentation.

Adolescent↗

PubMed2001

Cervical spine injuries among submersion victims.

BACKGROUND: Submersion victims are frequently considered at high risk for cervical spine (C-spine) injury regardless of whether they sustain a traumatic injury. We hypothesized that C-spine injury is unlikely in submersion victims who do not sustain high-impact injuries. METHODS: The study was a cohort study of all people who submerged between January 1974 and July 1996 and received medical care or were seen by the medical examiner in King, Pierce, and Snohomish counties in Washington State. RESULTS: Eleven (0.5%) of 2,244 submersion victims had C-spine injuries. All 11 had submerged in open bodies of water; had clinical signs of serious injury; and had a history of diving, motorized vehicle crash, or fall from height. No C-spine injuries occurred in 880 low-impact submersions. CONCLUSION: Submersion victims are at risk for C-spine injury only if they have also sustained a traumatic injury. Routine C-spine immobilization does not appear to be warranted solely on the basis of a history of submersion.

Adolescent↗

PubMed2001

Do we really need routine computed tomographic scanning in the primary evaluation of blunt chest trauma in patients with "normal" chest radiograph?

BACKGROUND: A major cause of morbidity and mortality after blunt chest trauma remains undetected injuries. This study evaluates the role of routine computed tomographic (CT) scan. METHODS: We studied 93 consecutive patients from January 1999 to July 2000: 73 (76.3%) after motor vehicle crash with crash speed > 10 mph, and 22 (23.7%) after fall from height > 5 ft. Simultaneous with initial clinical evaluation, anteroposterior chest radiograph and helical chest CT scan were obtained for all patients. RESULTS: Sixty-eight patients (73.1%) showed at least one pathologic sign on chest radiograph, and 25 patients (26.9%) had normal chest radiograph. In 13 (52.0%) of these 25 patients, the CT scan showed multiple injuries; among these were two aortic lacerations, three pleural effusions, and one pericardial effusion. CONCLUSION: Over 50% of patients with normal initial chest radiograph showed multiple injuries on the CT scan, among which were also two (8%) potentially fatal aortic lesions. We therefore recommend primary routine chest CT scan in all patients with major chest trauma.

Adolescent↗