Pattern of thoracolumbar spine fractures in kashmiri population following fall from walnut

Objectives: Aim of this study was to determine the pattern of thoracolumbar fractures due to fall from walnut trees in Kashmiri population. Patients and methods: 60 patients with history of trauma to spine following fall from walnut trees were included in this study. On arrival to the emergency ward of our hospital the patients were assessed and resuscitated as per ATLS protocol. After admission, the patients were subject to detailed history, thorough physical and neurological examination. X-rays of Thoracic & Lumbar spine were taken to know the level and extent of injury. CT scan was done to know the exact site of injury, fracture geometry and to classify the fractures. Results: All patients in our study were males with mean age of 37.5 years. The commonest level of vertebral involvement in thoracolumbar junction was L1 (53.33%) followed by D12 (21.67%) and L2 (16.67%) . As per McAfee classification 32 (53.33%) patients had unstable burst fractures, 14 (23.33%) patients had flexion distraction injuries, 10 (16.67%) patients had wedge compression fractures and 4 (6.67%) patients had stable burst fractures. Although most of our patients were neurologically intact, the patients withneurodeficit comprised a good amount of 30% of the cases.Among 60 cases of thoracolumbar spine fractures 27 patients had associated injuries. Conclusion: Fall from walnut trees constitute a major cause of morbidity in people engaged in this occupation. Proper education, training and newer methods of walnut harvesting should be adopted by Kashmiri people involved in such occupation.