Fatal falls involving stairs: an anthropological analysis of skeletal trauma
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ORIGINAL ARTICLE
Fatal falls involving stairs: an anthropological analysis of skeletal trauma Samantha K. Rowbotham 1
&
Soren Blau 1,2 & Jacqueline Hislop-Jambrich 3 & Victoria Francis 2
Accepted: 13 February 2018 # Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract The skeletal blunt force trauma resulting from fatal falls involving stairs is complex. There are countless ways an individual may fall when stairs are involved, and thus a variety of ways the skeleton may fracture. Therefore anecdotally, it may be said that there is no specific skeletal trauma characteristic of this fall type. In order to scientifically investigate this anecdotal understanding, this study provides a detailed investigation of the skeletal fracture patterns and morphologies resulting from fatal falls involving stairs. Skeletal trauma was analyzed using the full-body postmortem computed tomography scans of 57 individuals who died from a fall involving stairs. Trauma was examined in the context of the variables that potentially influence how an individual falls (i.e. sex, age, body mass index, number of stairs involved, psychoactive drugs, pre-existing conditions, landing surface and manner of the fall) using logistic regression. Skeletal trauma primarily occurred in the axial skeleton. An analysis of fracture patterns showed the cranial base was less likely to fracture in younger individuals and the cervical vertebrae were more likely to fracture in falls that involved more than half a flight of stairs. A total of 56 fracture morphologies were identified. Of these, diastatic fractures were less likely to occur in older individuals. Findings indicate that there are skeletal fracture patterns and morphologies characteristic of a fatal fall involving stairs. Keywords Forensic anthropology . Forensic pathology . Fatal fall . Fall involving stairs . Skeletal trauma . Blunt force trauma . Postmortem computed tomography . Fracture pattern . Fracture morphology . Autopsy . Bone
Introduction Falls involving stairs are a common type of accidental fall that can result in fatality. This is largely because stairs are an unavoidable object that most individuals encounter on a daily basis, whether in the home or public environment, which require complex biomechanical movements to navigate. Falls that involve stairs are arguably the most complex of all fall
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12024-018-9964-z) contains supplementary material, which is available to authorized users. * Samantha K. Rowbotham [email protected] 1
Department of Forensic Medicine, Monash University, 65 Kavanagh St, Southbank, Victoria 3006, Australia
2
Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, Victoria 3006, Australia
3
Centre for Medical Research, Toshiba Medical, 12 – 24 Talavera Rd, North Ryde, New South Wales 2113, Australia
types in terms of understanding how the resulting blunt force trauma (BFT) manifests on the skeleton. This complexity
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