FALLING FROM HEIGHT: AN INTERESTING UNUSUAL PATTERN OF INJURIES

ntroduction: Falling from height is considered a major public health problem being the second leading cause of unintentional injury death, after road traffic injuries. Falling represents a specific type of blunt force trauma, which is produced by rapid vertical deceleration and impact. There is no adequate literature available with reference to the type and pattern of injuries sustained in cases of falling from heights. Aim of the work: The aim of the present study was to analyze the different patterns of injuries sustained in victims of falling from different heights looking for recording possible uncommon patterns of injuries and to detect the incidence of substance abuse among them. Patients and methods: This study is a cross sectional statistical study of 200 cases of falling from different heights presented to Alkasr Alainy Emergency department during a period of six months from July to December 2013. Data collected included age, gender, occupation, circumstances of fall, height of falling, nature of landing surface, site and type of injuries sustained due to falling, besides calculation of injury severity score (ISS) for each case. In addition; urine dipstick test for detection of drugs of abuse was done for each case using the commercial kit (Abon Biopharm, Hangzhou, China). Results: Half of the cases fell from heights of one meter or less. Except for the three suicidal cases, the rest of the cases fell from height accidentally. The distribution of injuries took one of two forms; injuries in combined multiple sites of the body or injuries in isolated body region (uncommon pattern of injuries in cases of falling from height). At a height of one meter or less (low level), more than half of the cases had their injuries in the extremities while in higher heights, injuries were in combined multiple sites of the body. Blunt force wounds of the skin & subcutaneous tissue were the most common types of injuries in all cases. Urine dipstick test was positive in 21.5 % of cases. Only tramadol and cannabis were detected. Conclusion: It was concluded that falling from low heights is a very common phenomenon with its resultant injuries especially in the extremities. Injuries in isolated body region are not uncommon in cases of falling from height and represent one of the medicolegal challenges. External blunt force wounds were the most common type of injuries due to falling. In addition substance abuse is among the factors leading to falling from height.