Description

Velmahos et al evaluated patients who were injured as a result of urban free-falls. They identified patterns of injury which should be looked for in these patients. The authors are from the University of Southern California in Los Angeles.


 

Many people who suffer an urban free-fall are intoxicated on drugs and/or alcohol.

 

The landing surface is not described but is usually solid. Landing on a soft surface that might cushion the blow would be less likely.

Height Fallen

Percent Injured

Percent Fatal

<= 10 feet

49%

0%

11 - 20 feet

57%

2%

21 - 30 feet

92%

5%

31 - 60 feet

100%

20%

> 60 feet

100%

usually fatal

 

Common injuries:

(1) fractures of the extremities

(2) fractures of the vertebral spine

(3) fractures of the pelvis

(4) head and craniofacial injuries

(5) intra-abdominal organ injury

(5a) solid organ lacerations (liver and spleen)

(5b) small bowel perforation or injury to the mesentery

(5c) rupture of the urinary bladder

 

Less common injuries:

(1) other fractures

(2) intracranial hemorrhage (epidural or subdural)

(3) retroperitoneal injuries

(4) vascular rupture or pseudoaneurysms (aorta, major artery)

(5) pulmonary contusion or tear

 

Injuries that may need to be specifically excluded so that they are not overlooked:

(1) fractures of the vertebral spine

(2) vascular injuries

(3) intra-abdominal trauma

 

Complications:

(1) ARDS

(2) multiple organ failure

(3) neurologic deficits

 


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