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 433 records · Page 24Linked to original sources

PubMed1995

Falls: epidemiology and strategies for prevention.

Injury secondary to falls is a largely preventable public health problem. The records of 356 patients admitted following a fall to a level I trauma center over a 32-month period were reviewed to determine the epidemiology and to define possible prevention strategies. Falls constituted 9% of total trauma admissions during this time period and had a mortality of 11% (38 of 356). Two hundred ninety-seven falls were accidental, 36 were due to violent criminal behavior, 16 were from suicide attempts, and 7 were from house fires. Sixty-one children under the age of 13 fell; only one died. Falls out of windows accounted for 36% of these falls with over three-quarters of children falling from three stories or less. Elderly patients (age more than 64 years) accounted for only 44 (14%) of falls but over 50% of the deaths. This mortality rate occurred despite the fact that the majority of these falls were from relatively low heights. There were 224 adult falls (ages 18 to 64 years); 36% were occupation-related, and most were by construction workers, roofers, or painters. The remaining adult fall victims had a high rate of unemployment and alcohol and drug use. This study identified several groups where risk factors for falling permit targeted prevention strategies. A large percentage of children who fell were preschool males who fell from windows and this may be related to the lack of window guard legislation in our area.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidental Falls↗

PubMed1993

Age and fatal work-related falls.

In the work environment, an increased risk of fatal injury from falls is seen at ages not normally considered to be old. This study examined fatality data from a National Institute for Occupational Safety and Health death certificate database and from Occupational Safety and Health Administration (OSHA) investigations to analyze the relationship of age to fatal work-related falls. For 1980 to 1986, death certificates reported 43,505 fatal work injuries in men, 4179 of which were from falls. Fatality rates from falls showed an increase for older workers beginning with the age group of 45-54, whereas fatal injury rates for other work-related causes did not increase until the age group of 55-64. OSHA investigations of 996 fatal work-related falls in 1984-1986 reported that falls from ladders accounted for 20% of fatal falls in workers aged 55 and over, significantly more than the average of 9% of all falls for workers of all ages. OSHA data also showed that fatal falls among older workers were associated with lower energy of impact, which means that the height of fatal falls tends to decrease with increasing age.

Accidental Falls↗

PubMed2006

Pattern of injuries in fatal falls from buildings.

When bodies are brought for autopsy it is sometimes unclear whether the injuries are due to a fall from a height or due to blunt trauma from other causes, especially when the bodies are found near buildings with no eyewitnesses available. Studies discussing the injury patterns in adults after falls exclusively from buildings are rare. A five-year retrospective study was carried out on 151 cases of fatal falls from buildings brought for autopsy. The aim was to assess the pattern of these injuries and identify features helpful in discriminating between these and injuries due to blunt trauma from other causes. The majority of cases comprised subjects who fell from heights of 10-20 feet (3-6m) with most falls occurring late at night or in the early morning. The pattern that emerged is quite distinct from ground level falls and pedestrian injuries. Abrasions are the commonest injury and bruises very rare. Lacerations are mostly on the head and skull fractures are evenly distributed between the vertex, base and vertex plus base. Subarachnoid haemorrhage is the commonest intracranial lesion. Extradural haemorrhage alone is rare. Fractures of ribs and cervical vertebrae are common and fractures of thoracic vertebrae and long bones are uncommon. Safety measures to prevent such falls have been suggested.

Accidental Falls↗

PubMedDate not supplied

Systemic factors are trophic in Thiry-Vella loop in the absence of luminal contents.

BACKGROUND/AIMS: Mucosal histology, crypt cell proliferation and brush border enzymes were measured in rats with varying degrees of Thiry-Vella fistulas, in order to compare the effect of systemic and luminal factors on adaptive growth and differentiation (brush border enzymes) in small intestinal epithelium. METHODOLOGY: Twenty-four male Wistar rats (300-350 g) were divided with three groups of eight which underwent the following operations: 20% Thiry-Vella fistula, 80% Thiry-Vella fistula and sham operation. RESULTS: 80% Thirty-Vella fistulas caused a functional short gut; in intestine remaining in continuity there were significant increases in segmental weight, protein, Alp activity and villus height, compared with sham-operated controls and 20% Thiry-Vella fistulas. There was a significant fall in villus height, crypt cell production in loops of 20% Thiry-Vella fistula rats not exposed to luminal contents compared with control segments of sham-operated rats. In contrast, loops of the 80% Thiry-Vella fistula rats were not atrophied despite the much greater distance from luminal nutrients; the villus height and PCNA-LI were higher than in 20% Thiry-Vella fistula rats, and at least as great as in sham-operated rats. CONCLUSIONS: This study indicates that atrophy does not occur in loops after 80% Thiry-Vella fistula because crypt cell proliferation is maintained in Thiry-Vella fistulas. Thus, the atrophic effect of diversion of luminal nutrients can be counteracted by systemic growth factors released as part of the adaptive response; luminal factors are not essential for maintenance of normal cellular turnover when there is a powerful stimulus to cell proliferation.

Animals↗

PubMed2002

[Retrospective analysis of facial fractures related to falls in 260 Japanese patients].

OBJECTIVE: Numerous epidemiological studies concerning fall-related injuries have been performed in the geriatric and orthopedic field to clarify the relation between the type of fall and fracture patterns. Although falls are a common cause of facial fractures, there is no study describing these relations. This study thus investigates the relationship between the type of fall and fracture pattern. MATERIALS AND METHODS: We analyzed 260 patients with fall-related facial fractures treated between 1995 and 2000 at the First Department of Oral and Maxillofacial Surgery, Osaka University Dental Hospital, Japan. These patients were classified into two groups: (1) those who suffered fractures by a fall from a standing position or lower and (2) those who suffered fractures by a fall from a level higher than the standing position. RESULTS: Fractures caused by falling from a standing position or lower was more common in older patients, especially in women beyond 70 years. The localization of mandibular fractures was not significantly different between the two groups. However, a high incidence of midface fractures was observed in the patients who fell from a higher position. These patients tended to suffer from central midface or dislocated fractures. CONCLUSION: The results were consistent with recent orthopedic studies, which suggest a relation between fractures in old patients and osteoporosis. A strong force caused by falls from a high position tends to act on the high portion of the midface. Our classification based on the height of the falls was able to demonstrate clearly the relation between etiological factors and fracture patterns. Therefore, it seemed reasonable to analyze patients treated in the Department of Oral and Maxillofacial Surgery, Heidelberg University, Germany, according to the same classification in order to compare both collectives.

Accidental Falls↗

PubMed1976

[Injuries of the pelvic bone and lower urinary pathways].

We are all witness of the rapid tempo of our life styles made possible by recent advances in modern technology. The powerful, fast automobiles used in our society are an important contributing factor in trauma and polytrauma. Etiology of injuries therefore are changing before our eyes. Based on statistics of the hospital taken on a series of 753 polytraumatized cases during 1961--1967, the most common etiological factor was automobile accidents. According to predictions for 1977, in Serbia there will be 70,000--105,000 injuries resulting from automobile accidents. 7,000 of these injuries will result in death, 36,000 will be severe injuries, and 62,000 will be minor injuries. These are frightening statistics, and further comment is not needed. Until recently, the principle cause of pelvic trauma was falling from high heights. However, today, statistics show that 60%--80% of all pelvic fractures occur in automobile accidents, only 19% are caused by falls, and 6.4% by industrial accidents. This illustrates the trastic change in etiology of fractures of the pelvis and trauma of the lower urinary pathways.

Accidents, Traffic↗

PubMedDate not supplied

[A hip fracture bandage for the prevention of femoral neck fractures in the elderly. The femoral neck fracture, a biomechanical problem].

In the industrial countries, the number of hip fractures will double or even triple in the next 20 years. Pathogenetically, it is a complex matter of medical as well as biosocial factors. Gerontoprophylactically, it is more a biomechanical problem. Therefore a light fall on to the hip at the greater trochanter is of the greatest importance. We have constructed an impact neutralizer, also designed as a hip fracture bandage, to absorb the impact forces which act on aged people during a fall. It is made of a special silicone rubber. The impact neutralizer permits an impulse amplification by a factor of approximately two. Also, the critical height of the fall is increased by a factor of three. That means that the number of hip fractures occurring in elderly people can be reduced by 30-50%, depending on the type of fall and assuming that all elderly people liable to fall wear the hip fracture bandage.

Aged↗

PubMed1975

Total body potassium and body fat estimation in relationship to height, sex, age, malnutrition and obesity.

1. Total body potassium was estimated by 40-K measurement with a high-sensitivity whole body counter in normal individuals over a wide age range and in patients who were obese or were grossly wasted as a result of various conditions which restricted food intake. 2. Potassal males and females, but when individuals of different age groups were matched for height, a significant fall in total body potassium with increasing age was observed only in males. Total body potassium of females was about 75% that of males of similar height when young, the sex difference decreasing with ageing. In the normal population, total body potassium was significantly correlated with height and with weight; regression equations for various relationships are given. 3. Fat-free mass was estimated from total body potassium, values of 65 and 56 mmol of potassium/kg fat-free mass being used for males and females respectively. Body fat estimated by this method correlated well with skinfold measurements over a wide range of body weight but in malnourished individuals having inadequate food intake there was considerable fat-free mass from total body potassium appear unsatisfactory in malnutrition. Considerable differences between expected and observed values of total body potassium were found in muscular individuals and in normal individuals who were thin but whose body weight was relatively constant. 4. The patients with malnutrition were low both in body fat as estimated by skinfold thcikness and in total body potassium estimated on the basis of height. Plasma potassium was, however, normal and potassium supplements did not increase the total body potassium. 5. Total body potassium of obese individuals was not significantly different from that of normal weight individuals on the basis of height. Total body potassium fell on weight reduction with a very low energy diet of 1260 kJ (300 kcal.) daily but changed little with a 3300 kJ (800 KCAY POTASSIUM WAS BEST PREDICTED FROM THE INDIVIDUAL'S HEIGHT. For those whose body weight was less than expected, the use of weight gave the best prediction but the error was considerable when the weight deviation was large.

Adipose Tissue↗

PubMedDate not supplied

Traumatic unilateral internuclear ophthalmoplegia.

A 23-year-old man was admitted for a closed head injury following a fall from a height of 5 meters from a ladder. Because of a C-7 burst fracture, a halo and halo vest were applied approximately 9 hours following the fall. Approximately 21 hours after the accident, the patient complained of diplopia. On neuro-ophthalmology evaluation, a unilateral internuclear ophthalmoplegia was noted. MRI of the brain, performed 3 days after application of the halo and vest, showed a small infarct at the posterior aspect of the inferior midbrain, slightly left of midline. At 9.5 weeks there was 90% improvement of the internuclear ophthalmoplegia noted. Of the reported cases in the medical literature of traumatic internuclear ophthalmoplegia, 30 (83.33%) cases were male and 6 (16.67%) were female. The mean age was 31.7. 54% of the cases were bilateral; 46% unilateral. Mechanisms include: motor vehicle accident: 28 (41.79%), fall: 7 (10.45%), blunt trauma: 11 (16.42%), penetrating trauma 1: (1.49%), bike accident 3: (4.48%), other: 1 (1.49%), Unknown: 16 (23.88%).

Adult↗

PubMed1976

Muscle responses during sudden falls in man.

1. E.m.g. activity in soleus during an unexpected fall is found to be more complex than that described by Melvill Jones & Watt (1971b). After a silent period of about 80 msec an initial peak of activity lasts until about 100 msec after release. In falls from sufficient heights a second peak of activity occurs before landing. 2. The initial peak of activity is found in muscles throughout the body and is absent during falls in which the subject releases himself. It is suggested that this initial peak is a startle response to release and on landing during the initial peak any deceleration due to tension in the leg muscles is in part coincidental. 3. The second peak of activity is found in muscles of the lower limbs. Its timing is related to the timing of landing. It is suggested that this is the activity concerned in thhe voluntary control of landing. 4. No initial peak of activity could be recorded in two patients with absent labyrinthine function.

Acceleration↗

PubMed1994

Effects of loading rate on strength of the proximal femur.

Results from previous quasi-static mechanical tests indicate that femurs from elderly subjects fail in vitro at forces 50% below those available in a fall from standing height. However, bone is a rate-dependent material, and it is not known whether this imbalance is present at rates of loading which occur in a fall. Based on recent data on time to peak force and body positions at impact during simulated falls, we designed a high rate test of the femur in a loading configuration meant to represent a fall on the hip. We used elderly (mean age 73.5 +/- 7.4 (SD) years) and younger adult (32.7 +/- 12.8 years) cadaveric femurs to investigate whether (1) the strength, stiffness, and energy absorption capacity of the femur increases under high rate loading conditions; (2) elderly femurs have reduced strength, stiffness, and energy absorption capacity compared with younger adult femurs at this loading rate; and (3) densitometric and geometric measures taken at the hip correlate with the measured fracture loads. Femurs were scanned using dual-energy X-ray absorptiometry (DXA) and then tested to failure in a fall loading configuration at a displacement rate of 100 mm/second. The fracture load in elderly and younger adult femurs increased by about 20% with a 50-fold increase in displacement rate. However, energy absorption did not increase with displacement rate because of a twofold increase in stiffness at the higher loading rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

PubMed1999

Spinal cord injury and snowboarding--the British Columbia experience.

Snowboarding is an alpine sport growing in popularity, particularly among male youth. This study of 10 consecutive cases admitted to the Vancouver Hospital and Health Sciences Centre Acute Spinal Cord Injury Unit, over the 1997 to 1998 winter season, analyzes the epidemiology of snowboarding spinal injury. Information was collected retrospectively on the mechanism, location, and pattern of injury, and personal details of the individuals who suffered the injuries. The average age at time of injury was 22.4 years, with a range of 16 to 29. All but 1 of the cases were self-acknowledged expert-level snowboarders, with an average of 6.25 years experience. Nine of the injured were male. There was only 1 cervical injury, with the majority being low thoracolumbar, and 4 incidences of L-1 fracture. Compression and burst fracture were the predominant vertebral fracture patterns and there was a 50% incidence of significant neurologic injury and deficit. The most common mechanism of injury was axial loading following a failed jump or fall from a height, varying from 2 to 25 feet. The lack of associated injuries in 9 of the cases suggests a limited ability of the extremities to offset such falls. Contributing factors included the inherent riskiness of the sport, participant characteristics, lack of formal instruction, and self-constructed jumps. Poor weather conditions, unfamiliarity with a run, collisions, and consumption of alcohol also played lesser roles. The frequent association between spinal fracture and significant neurologic deficit in this group has not previously been reported in other studies.

Adolescent↗

PubMed2003

[Maxillofacial trauma by defenestration: 64 cases].

OBJECTIVE: There has been little work reported in the literature concerning trauma resulting from high level falls and almost none devoted to maxillofacial trauma following defenestration. The purpose of this work was to report the first series of defenestration victims who incurred maxillofacial trauma. METHOD: This retrospective series included all patients treated at the Pitié-Salpêtrière hospital between July 1994 and July 1999, all units included: surgery intensive care, neurosurgical emergency, orthopedic surgery or maxillofacial surgery. RESULTS: Female gender predominated in comparison with studies concerning high level falls (SR=0.5) with no difference concerning age (mu=31.5, sigma2=9.1). Fifty percent of the patients had a maxillofacial involvement. Death ensued in 17.2% (11/64 patients). The height of the fall among survivors ranged from one floor to eight floors; third-floor falls accounted for 31%. Defenestration was intentional in 70.3% of the cases, accidental in 17.1% and undetermined in 12.6%. The suicide attempts involved 13 patients with maniac depressive psychosis, 11 with depression, 6 with schizophrenia, 2 with undetermined familial problems, and 12 with no specific history. Four patients were drug abusers and 3 were alcoholics. Fifty percent of the victims were living in precarious social and economical conditions. The maxillofacial injuries included: 20 mandibular fractures, 15 Lefort fractures (I, II, III or combined), 2 blow out fractures, 7 fractures of the orbital roof, 15 fractures of the malar bone, 7 fractures of the nose bones, and 11 fractures of the naso-ethmoïdo-maxillo-fronto-orbital complex. On the average, patients lost 6 dental elements. The mean Glasgow index was 7.9. Extrafacial injuries included limb fractures (89%), chest trauma (73.4%), brain lesions (67%), spinal injury (40.6%), and abdominal injury (26.5%). CONCLUSION: The psychic and social vulnerability of the defenestration patient aggravated by the trauma is a fundamental dimension which must be taken into consideration during the initial management of these patients.

Accidental Falls↗

PubMedDate not supplied

[Methods of suicide in an autopsy sample of the Institute of Forensic Medicine of the Hannover Medical School].

Between 1978 and 1987 513 cases of suicide were examined at the Institute of Legal Medicine of the Medical School of Hannover (337 males (65.7%) and 176 females (34.3%). The greatest share of the suicides was found in the age group 18 to 30. 42.1% of the cases showed positive alcohol concentrations with men accounting for a relatively higher share. The most frequently used methods for committing suicide were intoxications (28.1%), hanging (25.3%), firearms (17.2%), falling from great height (9.7%) and drowning (7.6%). The incidence in terms of sex showed marked differences in distribution, however. Women mostly used the following methods for committing suicide: Intoxication (37.4%), falling (17.6%) and hanging (17%). With men we found the following order: Hanging (29.7%), firearms (24.3%) and intoxications (23.1%). Compared with other institutes of legal medicine the five most frequent suicide methods showed similar distributions, but with a higher rate of intoxications. On the other hand there were distinct differences as to the relative frequency of the individual suicide methods in the total population and the respective number of autopsies performed. Especially in cases of gunshot wounds the number of autopsies performed to rule out homicide was higher. Of 2390 case of suicide registered in Greater Hannover an autopsy was ordered by the court in only 6.7%. According to our experience the autopsy rate seems too low, because homicide in the form of pretended suicide is not too rare.

Adolescent↗

PubMed1994

A new model of diffuse brain injury in rats. Part II: Morphological characterization.

A new model producing diffuse brain injury, without focal brain lesions, has been developed in rats. This has been achieved by allowing a weight of 450 gm to fall onto a metallic disc fixed to the intact skull of the animal which is supported by a foam bed. Two levels of injury were examined by adjusting the height of the falling weight to either 1 m or 2 m. Two groups of animals were studied. Group 1 animals were separated into three subgroups: 10 received a 1-m weight drop, 58 received a 2-m weight drop, and 13 served as controls; all were allowed to breathe spontaneously. Group 2 animals were separated into the same subgroups: four received a 1-m weight drop, six received a 2-m weight drop, and four served as controls; all of these were mechanically ventilated during the procedure. In Group 1, morphological studies using light and electron microscopy were performed at 1, 6, 24, or 72 hours, or 10 days after insult; all Group 2 rats were studied at 24 hours after injury. Results from Group 1 animals showed that no mortality occurred with the 1-m level injury, while 59% mortality was seen with the 2-m level injury. On the other hand, no mortality occurred in Group 2 animals regardless of the level of trauma induced. However, the morphological changes observed in both groups were similar. Gross pathological examination did not reveal any supratentorial focal brain lesion regardless of the severity of the trauma. Petechial hemorrhages were noticed in the brain stem at the 2-m level injury. Microscopically, the model produced a graded widespread injury of the neurons, axons, and microvasculature. Neuronal injury was mainly observed bilaterally in the cerebral cortex. Brain edema, in the form of pericapillary astrocytic swelling, was also noted in these areas of the cerebral cortex and in the brain stem. Most importantly, the trauma resulted in a massive diffuse axonal injury that primarily involved the corpus callosum, internal capsule, optic tracts, cerebral and cerebellar peduncles, and the long tracts in the brain stem. It is concluded that this model would be suitable for studying neuronal, axonal, and vascular changes associated with diffuse brain injury.

Animals↗

PubMed1999

[Proximal femoral fractures in the elderly: pathogenesis, sequelae, interventions].

Hip fractures are a health problem of paramount importance for the individual and society. They are associated with a sharp increase of the incidence of immobility, dependency, nursing home placement, and death. In Germany, more than 100,000 elderly suffer a hip fracture every year. 90% of fractures of the proximal femur result from a fall with an impact near the hip. The kinetic energy of a fall from standing height without successful protective reactions is far above the fracture threshold of a femur in a man aged 70 and older, regardless of osteoporosis and sex. Therefore, propensity to fall and mechanisms of falling are more important in the pathogenesis of hip fracture than bone mineral density alone. The combination of age-associated gait and balance disorders, which increase the probability of falls, and age-related decreasing strength of the femur is responsible for the high incidence of hip fractures. Besides the interventions to reduce the fall frequency it is possible to decrease the number of hip fractures by a passive protection of the trochanter. An energy-shunting protector (crash helmet-like, hip padding) has been developed by Lauritzen and Lund (safehip). The protector consists of two stiff shells, sewn into special undergarment. The shells disperse the impact away from the trochanter to soft tissue, and increase the area of contact. A controlled study among nursing home residents has demonstrated a relative risk of hip fracture of 0.44 (95% CC 0.21 to 0.94) in the intervention group, i.e., the protector has reduced the number of hip fractures by more than a half. No hip fracture has happened during use of the protector. Using the protector can improve self-confidence and diminish self-restraint of physical activity, which is not rarely caused by fear of falling. Further investigations of compliance are necessary.

Aged↗

PubMed2000

Jumping from the Westgate Bridge, Melbourne.

OBJECTIVE: To describe characteristics of people who jumped from the Westgate Bridge (identifying risk factors for attempted suicide) and to determine why people may survive such a jump. DESIGN AND SETTING: A retrospective case review (coroners' reports and hospital records) of all people known to have jumped from the Westgate Bridge between 1991 and 1998. RESULTS: We identified 62 people who jumped from the Westgate Bridge over the study period. Seven survived. Forty-one (74%) of those who jumped were male. The average age was 33.8 years (range, 15-58 years). Forty-four (71%) had known mental illness (23 schizophrenia, 21 depression). Thirty-nine (63%) landed in water, falling from a height of 58.5 m. Nineteen (31%) fell onto land and in four cases (6%) the landing site was not determined. All survivors landed in water. Six people died from drowning after the fall, and in eight more deaths drowning was a major or contributing factor. All jumps resulted from suicidal intent, and 12 people (19%) had positive toxicology screens for alcohol or other non-prescription drugs at postmortem. CONCLUSIONS: Each year the Westgate Bridge is the scene of about eight suicide attempts by jumping (particularly by men with active psychiatric illness). Some deaths by drowning could be prevented by early detection and rapid emergency service response. The erection of an effective safety barrier would probably prevent more deaths.

Adolescent↗

PubMed1998

Normal growth in the short normal prepubertal child: the Wessex Growth Study.

OBJECTIVE: The study aimed at defining the normal rate of growth for short, prepubertal children, and comparing their pattern of growth with those of average stature. SETTING: Community based. DESIGN: Observation of an unselected population of 109 very short, normal prepubertal children (< 3rd height centile) and 107 controls matched for age and sex (10th to 90th centile). MAIN OUTCOME MEASURES: Height, velocity, change in height standard deviation score, from 6 to 9 years of age. RESULTS: The absolute mean rate of growth was significantly different between groups--short normal 5.3 cm/year, controls 5.9 cm/year--corresponding to velocities on the 25th and 50th centiles, respectively. The relative growth rates, however, as shown by the changes in height standard deviation score (short normal 0.10 (SD 0.22), controls 0.10 (SD 0.24) did not differ, and each group remained close to its original 3rd and 50th centiles. Two short children showed "catch up" growth after adoption, but, otherwise, the divergence from their original height centile was the same for short normal and control children. No social or biological factors were found to predict growth rate in the short normal children, and only target height in controls. "Normal" velocity is conditional on height. Short normal children do grow more slowly than children of average stature, but they do not necessarily grow more poorly. From 6 to 9 years of age they are no more likely to fall off their height centiles than children of average stature. The value of height monitoring at this age is questioned.

Body Height↗