title: Retrospective analysis of free-fall fractures with regard to height and cause of fall.
abstract: Free-fall fractures represent a specific form of blunt force trauma that can be hard to interpret because of the numerous factors that affect it. The aim of this study is to focus on skeletal injury patterns resulting from free-falls and to analyse the relationship between specific skeletal fractures, and the height and cause (accidental vs. suicidal) of the fall. A total of 179 autopsy reports of fatal free-falls from known heights were analysed at the Department of Forensic Medicine and Criminalistics, in Rijeka, Croatia. The location, type and frequency of fractures, as well as the number and distribution of fractured regions were analysed with regard to height and cause of fall. Height was found to be the major factor influencing fracture patterns in free-falls. In our sample, the frequencies of thoracic fractures, fractures to the extremities and those to the pelvis increased with height. Head fractures show no such relationship. However, types of fractures recorded in different anatomical regions, including the cranium, differ between height groups suggesting different injury mechanisms in each. Victims of falls generally sustained fractures in more than one body region, and the number of injured regions correlates significantly with height. Although no statistical difference was found in the number of fractured regions or frequency of fractures between accidental fallers and suicidal jumpers, jumpers showed a significantly higher number of bilateral extremity fractures when compared to victims of accidental falls. Logistic regression analyses also demonstrate a significant relationship between lower extremity fractures, and the cause of the fall. Our results highlight the need for further investigations of the influence that behaviour and height have in free-fall fractures.
authors: Department of Forensic Medicine and Criminalistics, Rijeka University School of Medicine, Brace Branchetta 20, 51 000 Rijeka, Croatia. anja.petaros@yahoo.com
authors: Anja
authors: A
authors: Petaros
authors: Mario
authors: M
authors: Slaus
authors: Miran
authors: M
authors: Coklo
authors: Ivan
authors: I
authors: Sosa
authors: Morana
authors: M
authors: Cengija
authors: Alan
authors: A
authors: Bosnar
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049429:Forensic Pathology; D050723:Fractures, Bone / Q000209:etiology / Q000473:pathology*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009104:Multiple Trauma / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D013405:Suicide / Q000706:statistics & numerical data; D055815:Young Adult