Korean J Neurotrauma.  2014 Oct;10(2):70-75. 10.13004/kjnt.2014.10.2.70.

Burst Fractures as a Result of Attempted Suicide by Jumping

• Kim DY
• Choi HJ
• Park JY
• Kim KH
• Kuh SU
• Chin DK
• Kim KS
• Cho YE
• Jin BH

• KMID: 2256234
• DOI: http://doi.org/10.13004/kjnt.2014.10.2.70

Abstract

OBJECTIVE
Jumping from high place for the purpose of suicide results in various damages to body area. A burst fracture of vertebrae is representative of them and we reviewed eight patients who were diagnosed with spinal burst fracture following suicide falling-down. The demographics, characteristics, performed operation, combined injuries, psychological past histories of the patients were analyzed.
METHODS
A retrospective study was made of patients who are diagnosed with vertebral burst fracture from falling-down with the purpose of suicide admitted to department of neurosurgery of the author's hospital, covering the period between 2003 and 2012.
RESULTS
Total eight patients were suicidal jumper. There were eleven vertebral burst fractures in eight patients and mean age was 26.5 years old. Seven patients already had psychological past history and there were various combined injuries except vertebrae burst fracture. The ankle fracture such as calcaneus, talus, navicular and malleolus was the most common injury and there were also various combined injury.
CONCLUSION
Suicidal jumper is different from incidental faller in some aspects because of different injury mechanism. For managing suicidal jumper, physician had to consider patients' age, affected site, psychiatric problem and combined injuries. Each department related to the injuries of patient have to cooperate each other with departments of psychiatry and rehabilitation from beginning to end.

Keyword

Spinal fractures; Burst fracture; Vertebrae; Suicide attemped

MeSH Terms

Ankle Fractures
Calcaneus
Demography
Humans
Neurosurgery
Rehabilitation
Retrospective Studies
Spinal Fractures
Spine
Suicide
Suicide, Attempted*
Talus

Figure

• 

  FIGURE 1 A 17-year-old girl jumped from a height of five stories visited the emergency room for back pain due to a suicide attempt. (A) Plain film, (B) computed tomography (CT), and (C) magnetic resonance imaging (MRI) show L1 burst fracture. She underwent pedicle screw fixation and posterolateral fusion with autologous bone on T11, T12, L1, and L2 [(D, E) plain film, (F) axial CT view, (G) axial MRI view].

• 

  FIGURE 2 A 29-year-old woman visited the emergency room for quadriparesis after a suicide attempt by jumping from a height of three stories. She was diagnos-ed with a burst fracture at the C7. A: She underwent two operations for the C7 burst fracture, the first being a corpectomy of C7 and an-terior cervical interbody fusion of C6, C7, and T1. B, C: Several days later, she underwent lateral mass fixation of C4, C5, and C6 and pe-dicle screw fixation of C7, T1.

• 

  FIGURE 3 A 21-year-old man visited the emergency room for quadriparesis after a suicide attempt by jumping from a height of five meters. He was diagnosed with a burst fracture of the L5 vertebra, a type III sacral fracture, and a right medial malleolus fracture [(A) lateral view of plain X-ray, (B) sagittal reconstructive view of computed tomography, (C) sagittal view of T2 weighted image magnetic resonance imaging (MRI)]. He underwent posterolateral fusion of L3, L4, L5, and S1 with pedicle screw fixation of L3, L4, and L5 and iliac screw fixation of S1 for the L5 burst fracture and the sacral fracture [(D, F) plain film, (E) axial MRI after operation].

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  FIGURE 4 Calcaneal fractures are commonly combined with bu-rst fractures from falls as a result of attempted suicide. A: Plain X-ray. B: 3D-reconstructive comput-ed tomography.

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