engleski

Freefall trauma: analysis of fractures with regard to height and cause of fall

Introduction: Trauma analysis has become one of the new key areas of forensic anthropological research. Freefall trauma represents a specific form of blunt force trauma which results from the impact of a body on a surface. Due to numerous factors that affect it, freefall trauma is one of the hardest to interpret. Although the frequency and severity of freefall injuries has been studied by numerous authors, they have most often focused on soft tissue and organ injuries and many have not examined realtionship between fractures and height of fall. The aim of this study was to focus exclusively on skeletal fractures resulting from freefalls by examining their relation to the height and cause of fall. Materials and Methods: 179 autopsy reports of fatal freefalls of known height were analyzed. The location, type and frequency of fractures, the number and distribution of fractured regions was analyzed with regard to height and cause of fall. Statistical analysis was performed using correlation matrices and difference tests. Logistic regression was used to attest the relationship between the frequency of fractures and selected independent variables such as height, cause of fall and age. Results: The area more susceptible to fractures has shown to be the thorax, followed by the head, spine, lower, upper extremities, and pelvis. The frequency of all fractures, excluding head fractures, increased with altitude, supporting logistic regression data. Thorax, upper and lower extremities showed the most significant increase. The frequency of specific head, thoracic, pelvic and arm fractures and the distribution of fractures changed also in dependence on height. Victims of falls sustained mostly fractures of more than 1 body region, and the number of injuried regions correlated significantly with height. The comparison between victims of suicides and accidental falls was performed on cases belonging to the same height group. Although no statistical difference was found in the number of fractured regions or frequency of fractures, a higher affection of lower body parts was noted in suicide victims, supporting the results of logistic regression analysis. Discussion and Conclusions: Height has demonstrated to be the major factor influencing freefall fractures. Frequency of fractures, type of fracture and number of fractured regions vary with regard to it. Although differences found between suicide victims and accidental falls cannot be considered significantly discriminating, the results emphasize the need for further investigation of the influence of behavior on freefall injuries.

forensic anthropology; falls from height; fractures; suicide

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