口腔外科治療を要した墜落・転落症例の傾向 −自殺企図と偶発的事故の特徴の解析

• Published in: 日本口腔外科学会雑誌 Vol. 66; no. 8; pp. 354 - 359
• Main Authors: 近藤, 誠二, 橋口, 志保, 喜多村, 泰輔, 眞野, 亮介, 喜多, 涼介, 吉野, 綾
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.08.2020
• Subjects: チームアプローチ; 墜落・転落; 飛び降り自殺; 骨折
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.66.354

Falls from heights represent one of the principal causes of multiple injuries and are usually associated with maxillofacial trauma. The aim of this study was to compare the distribution of injuries between patients who have fallen accidentally and those who have jumped from a height, and to reveal the features of the resulting injuries. A total of 494 patients treated in the Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, between June 2009 and May 2019, who were classified as either having fallen (fallers) or who jumped (jumpers) from a height were studied. Fifty-one patients (10.3%) were treated in the Department of Oral and Maxillofacial Surgery, among whom 22 were jumpers and 29 were fallers. Jumpers were younger (mean age, 28.5 vs. 47.0 years), more likely to be female (8 males, 14 females vs. 22 males, 7 females) and sustained significantly more fractures of the jaw (72.7% vs. 31.0%, p=0.043), pelvis (54.5% vs. 13.8%, p=0.002), and lower limbs (77.3% vs. 27.6%, p=0.001). Jumpers tended to land feet-first, resulting in fractures of the lower limbs, pelvis, and jaw. As for treatment, open reduction and internal fixation were conducted in a significantly higher proportion of jumpers than fallers (59.1% vs. 20.7%, p=0.005). In addition, an extraoral surgical approach for the management of mandibular fractures was used in a significantly higher proportion of jumpers than fallers (72.7% vs. 42.9%), reflecting the common injury patterns. The injury patterns identified by this study are expected to facilitate the more rapid assembly of treatment teams.