Abder-Rahman Hasan, Jaber Mohanad S O, Al-Sabaileh Shrouq S
Department of Pathology, Microbiology and Forensic Medicine, Faculty of Medicine, Jordan University Hospital, Jordan.
J Forensic Leg Med. 2018 Feb;54:69-73. doi: 10.1016/j.jflm.2017.12.001. Epub 2017 Dec 21.
Falling from a distance is an important issue worldwide, which happens in different ages, genders and circumstances. It is usually not considered a medicolegal case in many countries hence no autopsy is performed. This study focused on analyzing injuries sustained in victims of falling in relation to different distances of fall.
Retrospective study of 352 autopsy reports of falling victims brought to the forensic pathology department at Jordan University Hospital during the period from January 1990 to March 2016.
Among 352 cases, 256 (72.7%) were males and 96 (27.3%) were females. 303 (86.1%) cases showed accidental fall, 31 (8.8%) were suicidal, 2 (0.6%) were homicidal and un-clarified death in 16 (4.5%). Time of death was directly proportionate with the distance of fall. Victims fell from distances less than 3 m were 123 (35%), most of them were children less than 7 years 50 (40.5%) and unemployed adults more than 45 years were 48 (39.1%). They showed multiple abrasions (62.6%), few contusions (64.2%) and absent laceration of the skin (84.5%). Victims fell from distances of 3-9 m were 123 (35%), most of them were male workers 56 (60.2%). They showed multiple abrasions (63.5%), few contusions (71%) and few lacerations of skin (50.5%). Victims fell from distances more than 9 m were 136 (38.6%), most of them were male workers 71 (52.2%) and female servants 23 (17%). They showed few abrasions (80.9%), multiple contusions (64.7%) and few lacerations of skin (48.5%). The number of fractured limbs increases obviously with distances more than 3 m. Skull vault fractures were found in all distances, while skull base fractures showed in distances of 3-9 m and more than 9 m. Head injury was the most common fatal injury in all distances. Chest injuries were prominent mainly in distances more than 3 m. While abdominal injuries were mainly prominent in distances more than 9 m.
This study showed the effect of different distances of fall in causing different types of injuries in falling fatalities. Internal injuries were in a direct proportion with distances of fall, while external injuries showed a great importance in interpretation of the way of fall.
高处坠落是一个全球性的重要问题，发生在不同年龄、性别和环境中。在许多国家，这通常不被视为法医学案例，因此不进行尸检。本研究重点分析了不同坠落距离的坠落受害者所受的损伤。
对1990年1月至2016年3月期间送往约旦大学医院法医病理科的352例坠落受害者的尸检报告进行回顾性研究。
在352例病例中，男性256例（72.7%），女性96例（27.3%）。303例（86.1%）为意外坠落，31例（8.8%）为自杀，2例（0.6%）为他杀，16例（4.5%）死因不明。死亡时间与坠落距离成正比。从小于3米的高度坠落的受害者有123例（35%），其中大多数是7岁以下的儿童50例（40.5%）和45岁以上的无业成年人48例（39.1%）。他们表现出多处擦伤（62.6%）、少量挫伤（64.2%）且无皮肤裂伤（84.5%）。从3 - 9米的高度坠落的受害者有123例（35%），其中大多数是男性工人56例（60.2%）。他们表现出多处擦伤（63.5%）、少量挫伤（71%）和少量皮肤裂伤（50.5%）。从大于9米的高度坠落的受害者有136例（38.6%），其中大多数是男性工人71例（52.2%）和女性仆人23例（17%）。他们表现出少量擦伤（80.9%）、多处挫伤（64.7%）和少量皮肤裂伤（48.5%）。肢体骨折的数量在大于3米的距离时明显增加。在所有坠落距离中均发现颅盖骨折，而颅底骨折出现在3 - 9米和大于9米的距离。在所有坠落距离中，头部损伤是最常见的致命伤。胸部损伤主要在大于3米的距离时较为突出。而腹部损伤主要在大于9米的距离时较为突出。
本研究显示了不同坠落距离对坠落致死中不同类型损伤的影响。内伤与坠落距离成正比，而外伤在坠落方式的判断中具有重要意义。
