Abstract :
Background: One of the most common injuries and death in India are caused by falling from heights. Although a majority of these bereavements are accidental and are due to a slip from higher altitudes like multi storey buildings, trees, construction sites, etc., alcohol consumption also plays a vital role. In such occurrences of death due to falling from heights, head injury is a very common phenomenon and it complicates the investigation procedure for the investigators and the medico legal experts to arrive at a conclusion because these injuries impersonate the injuries sustained from other accident cases like a road accident per say. Due to the absence of eyewitness in most of these cases, a detailed analysis on the pattern and the nature of the injuries is required to arrive at a conclusion. These injuries sustained vary owing to the site of impact and the stature from where the victim had fallen and the critical answer to the medico legal queries lies in a detailed autopsy of the victim’s body and a thorough examination at the scene of occurrence. On the account of a comprehensive study insufficiency in Tamilnadu, a modest attempt was made to analyse the pattern of head injuries sustained on the victims of fall from different heights and is presented as a cross- sectional study.
Materials and Methods: The case study on the fatal incidents of fall from height was recorded and analysed statically in a sampling of one hundred cases which was subjected to detailed autopsy in a tertiary care hospital. In this analysis the nature and pattern of injuries, data regarding the nature of fall, the site of primary impact, period of survival and a detailed examination of head injuries were all noted. The statistical analysis was carried out using Microsoft Excel 2009.
Results: From the analysis, it is observed that the maximum number of fall from height cases seemed to be from the age group of 31 years ~40 years (30%) and males contributed to a majority of these cases (90%). Amongst head injury cases, 82% of the cases had intracranial haemorrhage and 10% had facial bone fractures. In the 82% of cases, 76% of cases had both subarachnoid haemorrhage and subdural haemorrhage. Also skull fracture was seen in 40% of the cases and the base of the skull fracture was noted almost equally in 37% of the cases. Injuries to head and cervical spine constituted to the salient features of primary head impacts, SAH alone is rare in such cases.
Conclusions: On the account of observation and analysis, it is noted that most of these cases were accidental in nature (93%) and Males (90%) in the age group of 31-40 years were in highest number (30%). Cranial injuries with subarachnoid and subdural haemorrhage seemed to be the most common cause of death amongst victims falling from heights. Also skull fracture were seen in 40% of the cases and base of skull fracture noted almost equally in 37% of the cases. While SAH alone in rare in these cases, injuries to head and cervical spine were the key impacts of primary head impacts.
Keyword :
Fall from height, Site of impact, Pattern of injuries, Head injuries.