Abstract
Especially in urban settings, falls from height are a phenomenon that significantly contributes to population morbidity and mortality. The injuries sustained vary depending on the falling height, the composition of the impact surface, the position of the body when landing and individual factors such as age, body weight and preexisting disease. Cases of fatal falls from height can carry a high forensic relevance, because at the time the body is found, the manner of death is often unclear. Injuries sustained prior to the actual fall that might have been inflicted by another person might well be masked by the impact injuries. It is thus especially important in these cases to take into account not only the autopsy findings but also toxicology results, findings at the death scene, and the medical, psychiatric, and social history of the victim. The aim of this review is to summarize the most important findings in cases of fatal falls from height and to discuss the possibilities and limits in interpreting these findings with special regard to the manner of death.
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References
Bennett AT, Collins KA (2001) Elderly suicide: a 10-year retrospective study. Am J Forensic Med Pathol 22:169–172
Abrams RC, Marzuk PM, Tardiff K, Leon AC (2005) Preference for fall from height as a method of suicide by elderly residents of New York City. Am J Public Health 95:1000–1002
Türk EE, Tsokos M (2004) Pathologic features of fatal falls from height. Am J Forensic Med Pathol 25:194–199
Cetin G, Günay Y, Fincanci SK, Özdemir Kolusayin R (2001) Suicides by jumping from Bosporus Bridge in Istanbul. Forensic Sci Int 116:157–162
Gill JR (2001) Fatal descent from height in New York City. J Forensic Sci 46:1132–1137
Lewis WS, Lee AB Jr, Grantham SA (1965) “Jumper’s syndrome”. The trauma of high free falls as seen at Harlem Hospital. J Trauma 5:812–818
Scalea T, Goldstein A, Philips T, Sclafani SJ, Panetta T, McAuley J, Shaftan G (1986) An analysis of 161 falls from a height: the “jumper syndrome”. J Trauma 26:706–712
Roshkow JE, Haller JO, Hotson GC, Sclafani SJ, Mezzacappa PM, Rachlin S (1990) Imaging evaluation of children after falls from a height: review of 45 cases. Radiology 175:359–363
Risser D, Bonsch A, Schneider B, Bauer G (1996) Risk of dying after a free fall from height. Forensic Sci Int 78:187–191
Li L, Smialek JE (1994) The investigation of falls and jumps from height in Maryland (1987–1992). Am J Forensic Med Pathol 15:295–299
Shaw KP, Hsu SY (1998) Horizontal distance and height determining falling pattern. J Forensic Sci 43:765–771
Wischhusen F, Patra S, Braumann M, Türk EE, Püschel K (2006) Analysis of jumping/falling distance from a height. Forensic Sci Int 156:150–153
Chao TC, Lau G, Teo CES (2000) Falls from a height: the pathology of trauma from vertical deceleration. In: Mason JK, Purdue BN (eds) The pathology of trauma, 3rd edn. Arnold, London
Lecomte D, Fornes P (1998) Suicide among youth and young adults, 15 through 24 years of age. A report of 392 cases from Paris, 1989–1996. J Forensic Sci 43:964–968
Chute D, Grove C, Rajasekhara B, Smialek JE (1999) Schizophrenia and sudden death: a medical examiner case study. Am J Forensic Med Pathol 20:131–135
Gupta SM, Chandra J, Dogra TD (1982) Blunt force lesions related to the height of a fall. Am J Forensic Med Pathol 3:35–43
Harvey PM, Solomons BJ (1983) Survival after free falls of 59 m into water from the Sydney Harbour Bridge 1930-1982. Med J Aust 1:504–511
Lau G, Ooi PL, Phoon B (1998) Fatal falls from height: the use of mathematical models to estimate the height of fall from the injuries sustained. Forensic Sci Int 93:33–44
Goodacre S, Than M, Goyder EC, Joseph AP (1999) Can the distance fallen predict serious injury after a fall from a height? J Trauma 46:1055–1058
Steedman DJ (1989) Severity of free-fall injury. Injury 20:259–261
Isbister ES, Roberts JA (1992) Autokabalesis: a study of intentional vertical deceleration injuries. Injury 23:119–122
Katz K, Gonen N, Goldberg I, Mizrahi J, Radwan M, Yosipovitch Z (1988) Injuries in attempted suicide by jumping from a height. Injury 19:371–374
Mathis RD, Levine SH, Phifer S (1993) An analysis of accidental free falls from a height: the “spring break” syndrome. J Trauma 34:137–143
Atanasijevic TC, Savic SN, Nikolic SD, Djokic VM (2005) Frequency and severity of injuries in correlation with the height of fall. J Forensic Sci 50:608–612
Lucas GM, Hutton JE Jr, Lim RC, Mathewson C Jr (1981) Injuries sustained from high velocity impact with water: an experience from the Golden Gate Bridge. J Trauma 21:612–618
Bockholdt B, Maxeiner H (2000) Cervical findings and petechial hemorrhages in falls from high positions [Article in German]. Arch Kriminol 205:53–58
Plattner T, Kopp A, Bolliger S, Zollinger U (2004) External injuries to the neck after free fall from great height. Am J Forensic Med Pathol 25:285–287
De la Grandmaison GL, Krimi S, Durigon M (2006) Frequency of laryngeal and hyoid bone trauma in nonhomicidal cases who died after a fall from a height. Am J Forensic Med Pathol 27:85–86
Türk EE, Tsokos M (2004) Blunt cardiac trauma caused by fatal falls from height: an autopsy-based assessment of the injury pattern. J Trauma 57:301–304
Perchinsky MJ, Long WB, Hill JG (1995) Blunt cardiac rupture. Arch Surg 130:852–856
Fang BR, Kuo LT, Li CT, Chang JP (2000) Isolated right atrial tear following blunt chest trauma: report of three cases. Jpn Heart J 41:535–540
Duda AM, Ilada PB, Molnar RG, Bachulis BL (1999) Successful repair of blunt cardiac rupture involving both ventricles. Cardiovasc Surg 7:263–265
De Waele JJ, Calle PAA, Blondeel L, Vermassen FEG (2002) Blunt cardiac injury in patients with isolated sternal fractures: the importance of fracture grading. Eur J Trauma 3:178–182
Moulin A (2002) Cardiac contusion diagnosed by cardiac troponin. Am J Emergency Med 20:382–383
Salim A, Velhamos GC, Jindal A, Chan L, Vassiliu P, Belzberg H, Asensio J, Demetriades D (2001) Clinically significant blunt cardiac trauma: role of serum troponin level combined with electrocardiographic findings. J Trauma 50:237–243
Santaniello JM, Miller PR, Croce MA, Bruce L, Bee TK, Malhotra AK, Fabian TC (2002) Blunt aortic injury with concomitant intra-abdominal solid organ injury: treatment priorities revisited. J Trauma 53:442–445
Matthes G, Stengel D, Bauwens K, Seifert J, Rademacher G, Mutze S, Ekkernkamp A (2005) Predictive factors of liver injury in blunt multiple trauma. Langenbeck’s Arch Surg Nov 1:1–5
Brandes SB, McAninch JW (1999) Urban free falls and patterns of renal injury: a 20-year experience with 396 cases. J Trauma 47:643–650
Velmahos GC, Demetriades D, Theodoru D, Cornwell EE III, Belzberg H, Asensio J, Murray J, Berne TV (1997) Patterns of injury in victims of urban free-fall. World J Surg 21:816–820
Lowenstein SR, Yaron M, Carrero R, Devereux D, Jacobs LM (1989) Vertical trauma: injuries to patients who fall and land on their feet. Ann Emerg Med 18:161–165
Coman M, Meyer AD, Cameron PA (2000) Jumping from the Westgate Bridge, Melbourne. Med J Aust 172:67–69
Perret G, Flomenbaum M, La Harpe R (2003) Suicides by fall from height in Geneva, Switzerland, from 1991 to 2000. J Forensic Sci 48:821–826
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Türk, E.E. (2009). Fatal Falls from Height. In: Tsokos, M. (eds) Forensic Pathology Reviews. Forensic Pathology Reviews, vol 5. Humana Press. https://doi.org/10.1007/978-1-59745-110-9_2
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DOI: https://doi.org/10.1007/978-1-59745-110-9_2
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