Martin Lutz, Peter Mair
Untersuchung zu Verletzungsmuster und Verletzungsursache bei Stur z ins Kletterseil Investigation of trauma pattern and trauma mechanism in case of fall into a climbing rope S U M M A RY Several years ago an experimental land mark study by Schubert and Mägdefrau evaluated the forces acting on the human body during a fall into a climbing rope. From their data the authors concluded, that any larger fall will cause severe or even life threatening injuries when using a sit harness only. This is mainly due to the possibility of spine as well as abdominal organ injury secondary to hyperextension trauma. Aim of the current retrospective, clinical study was to clarify, whether the pattern of injury postulated by Schubert and Mägdefrau is indeed found in real life falls and contributes to the morbidity and mortality of individuals injured in climbing accidents. A total of 57 individuals with a history of a fall into the rope during rock climbing were studied. Height of the fall, body position during the fall, body position at suspension, difficulty of the climbing route, type of harness used (sit harness or a combination of a sit and chest harness) and the pattern of injury were analysed. We found a correlation between the difficulty of the climbing route and the severity of injury, with a clear peak of life threatening injuries and multi trauma cases in routes of low difficulty (UIAA class III and IV). Head down position was common during the fall (33 % of all cases) without any correlation to the harness used. Head down position was rather uncommon at suspension (10 % of all cases) and was only found when a sit harness was used without chest harness. A disruption of the thoracolumbal spine or abdominal organ injuries caused by the sole use of a sit harness were not found in any of our cases, despite a significant number of larger falls up to 60 meters. Taken together, severe and life threatening injuries in rock climbing accidents are almost exclusively due to rock contact during the fall and are more common in routes of low difficulty and with increasing height of the fall. We did not find any evidence that the type of harness used significantly influences the pattern or severity of injury in rock climbing accidents. 23
