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Head injuries in falls from a standing height: Do fractures of the orbital roof matter? A prospective autopsy study

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Abstract

Purpose

The aim of this study was to analyze the occurrence and characteristics of orbital roof fractures, periorbital hematoma, conjunctival hemorrhage, orbital roof discoloration, and concomitant head injuries in falls from a standing height.

Methods

A prospective autopsy study was performed over a 4-year period (from 2010 to 2013). Subjects who had died due to traumatic brain injury caused by falls from a standing height were included in the study.

Results

Fifty cases of ground level falls were recorded. This group consisted of 39 men and 11 women, with an average age of 67.3 ± 13.6 years, and median age of 70 years. Skull fractures originating in the proximity of impact site were found in 47 of 50 individuals, and 22 had isolated orbital roof fractures not connected to the fracture line. Bluish discoloration of the orbital roof was noted in 19 subjects, 14 had periorbital hematomas, and 12 had blotchy or purpura-like conjunctival hemorrhages.

Conclusions

Isolated orbital roof fractures in falls from a standing height are easily detected using a standard autopsy technique, with special regard to careful removal of the dura in the anterior cranial fossa. Our study shows that orbital roof fractures can occur in accidental falls from a standing height and may not be associated with concomitant skull fractures and brain injuries.

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References

  1. Chisholm KM, Harruff RC. Elderly deaths due to ground-level falls. Am J Forensic Med Pathol. 2010;31(4):350–4.

    Article  PubMed  Google Scholar 

  2. Sarani B, Temple-Lykens B, Kim P, Sonnad S, Bergey M, Pascual JL, Sims C, Schwab CW, Reilly P. Factors associated with mortality and brain injury after falls from the standing position. J Trauma. 2009;67(5):954–8.

    Article  PubMed  Google Scholar 

  3. Sharkey EJ, Cassidy M, Brady J, Gilchrist MD, NicDaeid N. Investigation of the force associated with the formation of lacerations and skull fractures. Int J Legal Med. 2012;126(6):835–44.

    Article  CAS  PubMed  Google Scholar 

  4. Verschueren P, Delye H, Depreitere B, Van Lierde C, Haex B, Berckmans D, Verpoest I, Goffin J, Vander Sloten J, Van der Perre G. A new test set-up for skull fracture characterisation. J Biomech. 2007;40(15):3389–96.

    Article  CAS  PubMed  Google Scholar 

  5. Hamel A, Llari M, Piercecchi-Marti MD, Adalian P, Leonetti G, Thollon L. Effects of fall conditions and biological variability on the mechanism of skull fractures caused by falls. Int J Legal Med. 2013;127(1):111–8.

    Article  PubMed  Google Scholar 

  6. Lignitz E, Henn V. New autopsy signs in violent death. Forensic Sci Int. 2007;165(2–3):172–7.

    Article  PubMed  Google Scholar 

  7. Geserick G, Prokop O, Kruse Ch. Frakturen der knochernen Orbita bei stumpfem Schadeltrauma mit Contrecoup-Verletzung. Kriminal Forens Wiss. 1980;39:53–7.

    Google Scholar 

  8. Guyomarc’h P, Campagna-Vaillancourt M, Chaltchi A, Sauvageau A. Skull fracture with brain expulsion in a one-level jumping-fall. J Forensic Sci. 2009;54(6):1463–5.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by Ministry of Science of Republic of Serbia, Grant No. 45005.

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Authors and Affiliations

  1. Institute of Forensic Medicine, University of Belgrade – School of Medicine, 31a Deligradska Str., 11000, Belgrade, Serbia

    Vladimir Živković & Slobodan Nikolić

Authors
  1. Vladimir Živković
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  2. Slobodan Nikolić
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Correspondence to Slobodan Nikolić.

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Živković, V., Nikolić, S. Head injuries in falls from a standing height: Do fractures of the orbital roof matter? A prospective autopsy study. Forensic Sci Med Pathol 10, 483–486 (2014). https://doi.org/10.1007/s12024-014-9583-2

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  • DOI: https://doi.org/10.1007/s12024-014-9583-2

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