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Atiç R, Alemdar C, Ulus SA, Yazar C, Durgut F, Sayar Ş, Aydın A. Outcomes of Lumbosacral Fixation in Patients with Suicidal Jumper's Fractures: A Retrospective Study from a Single Center in Turkey. Med Sci Monit 2024; 30:e942831. [PMID: 38225811 PMCID: PMC10802078 DOI: 10.12659/msm.942831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/13/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Suicide attempts that involve jumping from a great height may not be fatal but can result in lumbosacral facture-dislocations. This retrospective study aimed to present the experience from a single center in Turkey of 21 patients with lumbosacral facture-dislocations, or suicidal jumper fractures, treated with lumbosacral fixation between 2015 and 2022. MATERIAL AND METHODS The study included 21 patients. The diagnosis was established through X-ray and computed tomography (CT) examinations. Neurological damage was assessed using the Gibbons score. Among the patients, 2 were classified as Roy-Camille type 1, 12 as Roy-Camille type 2, and 7 as Roy-Camille type 3. Morphologically, 8 patients had H-type fractures, 7 had T-type fractures, and 6 had U-type fractures. Bilateral spinopelvic fixation was performed. Functional outcomes were evaluated using the Majeed score. RESULTS The average Injury Severity Score (ISS) was 31.6±12.2. The mean duration of surgery was 123.6±44.9 minutes. According to the Majeed score, excellent results were observed in 8 individuals (40%), good results in 5 individuals (25%), fair results in 5 individuals (25%), and poor results in 2 individuals (10%). Out of 18 patients with neurological deficits, 14 showed improvement after surgery, while 4 continued to experience deficits. CONCLUSIONS The findings from this study highlight the importance of obtaining a clear history of the cause of lumbosacral facture-dislocation, as attempted suicide by jumping from a height can cause specific types of injury to the lumbar spine and sacrum that require rapid diagnosis and management to reduce the incidence of permanent paraplegia.
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Affiliation(s)
- Ramazan Atiç
- Department of Orthopedics and Traumatology, Dicle University Medical School, Diyarbakır, Turkey
| | - Celil Alemdar
- Department of Orthopedics and Traumatology, Medicana International Hospital, Istanbul, Turkey
| | - Sait Anıl Ulus
- Department of Orthopedics and Traumatology, Mardin Training and Research Hospital, Mardin, Turkey
| | - Cihan Yazar
- Department of Orthopedics and Traumatology, Dicle University Medical School, Diyarbakır, Turkey
| | - Fatih Durgut
- Department of Orthopedics and Traumatology, Selçuk University Medical School, Konya, Turkey
| | - Şafak Sayar
- Department of Orthopedics and Traumatology, Biruni University Hospital, Istanbul, Turkey
| | - Abdulkadir Aydın
- Ataturk Vocational School of Health Services, Dicle University, Diyarbakir, Turkey
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Umana GE, Teli M, Chaurasia B, Passanisi M, Longo G, Spitaleri A, Fricia M, Tomasi SO, Ponzo G, Nicoletti GF, Cicero S, Visocchi M, Scalia G. Roy-Camille Type 3 suicidal jumper's fractures: Case series and review of the literature. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2021; 12:149-156. [PMID: 34194161 PMCID: PMC8214236 DOI: 10.4103/jcvjs.jcvjs_185_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/05/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Roy-Camille reported only three patients in their Type 3 posttraumatic transverse sacral fracture (TSF) classification. A modified Roy-Camille classification has been already proposed by other authors suggesting further categorization of the TSFs as partially displaced or completely displaced to predict the rate of neurological recovery following lumbopelvic fixation. Materials and Methods: We reported three adult cases of surgical fixation of fracture–dislocation (3A and 3B) of the sacrum due to traumatic injuries and submitted to lumbopelvic posterior reconstruction. A case of a 15-year-old male patient affected by Type 3C with vascular pelvic injury was also reported. A comprehensive literature search was performed on evaluation and management of Type 3 TSFs. Results: In Type 3A, there is a minimal anterior dislocation and the reduction is feasible with good chance of recovery. In Type 3B, the anterior dislocation is severe, neurological deficits are present, reduction is difficult, and there is a risk of vascular injury both at the trauma and during the surgical reduction. In Type 3C, the anterior dislocation is massive, and the risk of vascular injury is very high requiring prompt vascular or endovascular treatment. Open reduction and posterior instrumentation are technically feasible in patients affected by Type 3 high TSFs. Conclusions: In our opinion, a modified Roy-Camille classification could be useful in the assessment of prognostic and therapeutic aspects of such fractures, In our opinion, a modified Roy-Camille classification could help assess the prognostic and therapeutic aspects of such fractures, in which the severity of the dislocation affects the surgical technique, the chance of neurological recovery, and the patient's life expectancy.
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Affiliation(s)
- Giuseppe Emmanuele Umana
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Marco Teli
- Department of Neurosurgery, Walton Centre NHS Foundation Trust, Liverpool, England, UK
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj, Nepal
| | - Maurizio Passanisi
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Gianfranco Longo
- Department of Orthopedic Surgery, Trauma Center, Cannizzaro Hospital, Catania, Italy
| | - Angelo Spitaleri
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Marco Fricia
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Santino Ottavio Tomasi
- Department of Neurosurgery, Christian-Doppler-Klinik, Paracelsus Private Medical University, Salzburg, Austria
| | - Giancarlo Ponzo
- Neurosurgery Unit, Highly Specialized Hospital and of National Importance "Garibaldi," Catania, Italy
| | | | - Salvatore Cicero
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Massimiliano Visocchi
- Master CVJ Surgical Approach Research Center, Craniovertebral Junction Operative Unit, Institute of Neurosurgery, Policlinic "A. Gemelli," Catholic University, Rome, Italy
| | - Gianluca Scalia
- Neurosurgery Unit, Highly Specialized Hospital and of National Importance "Garibaldi," Catania, Italy
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Li LJ, Dong XM, Sun XC, Jia J. Treatment of ‘Suicidal Jumper Fractures’ with Lumbopelvic Fixation: A Report of Nine Cases. J HARD TISSUE BIOL 2021. [DOI: 10.2485/jhtb.30.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Li-Jun Li
- Department of Orthopaedics, The Second Hospital of Tianjin Medical University
| | | | - Xiao-Chen Sun
- Department of Orthopaedic Surgery, Tianjin Haihe Hospital
| | - Jian Jia
- Department of Orthopaedics, The Second Hospital of Tianjin Medical University
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