Multidetector computed tomography imaging of facial trauma in accidental falls from heights.
OBJECTIVE
To assess multidetector computed tomography (MDCT) findings in facial trauma in adults who accidentally fall from heights.


METHODS
Of the MDCT scans of 2413 cases requested by emergency-room physicians for suspected facial injury, 155 (age 15.3-76.7, mean 42.0 years; 134 male, 21 female) met the criteria of falling from heights. These were reviewed by two researchers by consensus.


RESULTS
Of these 155, 118 (104 male, 14 female) had 247 fractures, while 37 had no fracture. The fractures were classified into 13 categories, the zygomatic complex being the region most frequently involved. Mean falling height, known in 132 of 155 cases, was 5.7 m (range 0.4-25) in all, 6.0 m (0.4-25) in those suffering a fracture, and 5.0 m (range 0.4-13) in those without a fracture. Patients with Le Fort II, Le Fort III, or frontal bone fractures had fallen higher and frequently had associated skull base fractures, but with considerable overlap in falling heights. Zygomatic arch and nasal bone fractures rarely occurred solitarily.


CONCLUSIONS
In a fall-from-height injury, nasal bone and zygomatic arch fractures indicate the presence of more severe fractures. Height cannot solely predict injury probability. Clear sinus sign is a valuable aid in assessing midface trauma in falls from heights.
Salonen
E M
EM
Helsinki Medical Imaging Center, Department of Radiology, Töölö Trauma Center, Helsinki University Hospital, Helsinki, Finland. elina.m.salonen@hus.fi
Koivikko
M P
MP
Koskinen
S K
SK
D000058:Accidental Falls; D000293:Adolescent; D000328:Adult; D000368:Aged; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000293:injuries; D005151:Facial Injuries / Q000000981:diagnostic imaging*; D005260:Female; D005624:Frontal Bone / Q000000981:diagnostic imaging / Q000293:injuries; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008440:Maxillary Fractures / Q000000981:diagnostic imaging; D008875:Middle Aged; D009295:Nasal Bone / Q000000981:diagnostic imaging / Q000293:injuries; D019291:Skull Base / Q000293:injuries; D012887:Skull Fractures / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D015051:Zygomatic Fractures / Q000000981:diagnostic imaging