Injury Patterns Following Falls Down Open Manholes

Little is known of the possible injuries caused by a fall through an open manhole, with the last study published 40 years ago. The purpose of this study was to examine the injuries, surgical interventions, and outcomes in patients suffering from a fall through an open manhole or storm drain. All patients injured by falling through open manholes (ICD codes E883.2, W17.1) from 2007 to 2017 were queried from the National Trauma Data Bank (R) (NTDB). Transferred patients were excluded. Studied variables included patient demographics, comorbidities, emergency room physiology, toxicology, injury severity and pattern, surgical interventions, and outcomes. A total of 388 patients met study criteria. The number of patients injured from open manholes per year ranged from 20 (0.004%) to 49 (0.005%). Major trauma (ISS >= 16) occurred in 37 patients (10%). Severe injuries (AIS >= 3) most frequently occurred in the lower extremities (13%), chest (12%), and head (8%). Major surgery was performed in 18 patients (5%) and five (1%) died. Despite an increase in reporting in recent years, the number of patients who suffer severe injuries following a fall through an open manhole is low. Nonetheless, these injuries are easily preventable and mandate an increased focus on manhole safety.