574例高坠死亡案件分析

目的通过对大量高坠死亡案件的现场分析、尸体的损伤形态学观察并结合案情调查资料,构建高坠案件法医病理学案例库,为研究疑难坠落死亡案件奠定基础。方法收集并回顾分析5省市574例高坠死亡案件资料,包括死者个人信息、现场勘查资料、尸检结果、精神疾病史和毒物检验结果。结果男性的意外死亡率明显高于女性;在0～10岁年龄组未见自杀案例;在60岁以上年龄组,自杀率明显高于意外死亡;大多数的意外案例都发生在工作地点;坠落高度在10m以下的案例中,落地最先接触部位以头部居多,而在10～25m高度,足或下肢多见。结论大多数高坠案例都有明确的结论,但部分案例成伤机制及死亡方式判断呈现明显分歧,应为今后坠落伤研究的重点方向。     

246例高坠案件中坠落高度与损伤分析

目的对高坠案件进行统计分析,为相关鉴定研究提供参考。方法收集上海市浦东地区最近十年来记录有坠落距离的246例高坠案件,对人体损伤的特点进行比较分析。结果自杀高坠的高度显著高于意外高坠的高度(25.70m:13.98m);所有高坠中,头部损伤概率较高(75.2%),颈部损伤概率较低(6.5%);意外高坠的头部损伤概率高于自杀组(89.4%:75.2%)。结论意外高坠的死者比自杀高坠的死者更缺乏四肢对于头部的保护;过低的颈部损伤发现率提示国内法医工作者应该更加重视在高坠案件中的对于颈部损伤的检查。     

152例高坠死亡案件回顾性分析

目的对于高坠死亡案例进行回顾性调查分析,为相关研究和鉴定提供参考。方法收集2011年至2014年间,武汉市汉阳区范围内公安部门受理的所有高坠案件,共152例,对案件性质、高坠地点特征、死者年龄、性别、损伤情况等项目进行统计分析。结果 152例高坠死亡案件中自杀118例、意外28例,6例性质未能确定;高坠案件无论性质为何,发生地点均以居民住宅区最多;女性在自杀中占比略高,且年龄偏大(50岁),而意外高坠中全部为男性;损伤在两类性质的案件中均以头部和四肢为最多;自杀案件中有四分之一左右的死者有精神疾病史。结论国内高坠案件随着社会生活的发展有其独特的特征,而对高坠的尸体检验需要更加仔细和全面。     

205例高坠案件局部机械性损伤与死亡性质关系分析

目的探讨高坠案件中局部机械性损伤行为心理分析与死亡性质的关系,为此类案件的定性提供参考。方法收集2008—2013年高坠死亡案件311例,其中存在高坠难以形成的局部机械性损伤案例205例。对损伤形成特点、现场痕迹、高坠致命伤、文字信息等进行分析。结果 205例中,根据初步现场痕迹、高坠致命伤、文字信息等分析后,明确自杀86例,意外24例,性质不明95例。95例性质不明案例经对局部机械性损伤进行行为心理分析后,认定自杀80例,意外11例,他杀4例。结论高坠难以形成的局部机械性损伤与死亡性质具有关联性,根据局部机械性损伤行为心理分析推断高坠死亡性质基本准确。     

391例高坠死亡案件鉴定分析——以上海市徐汇区为视角

目的对上海市徐汇区近十年高坠死亡案件的检验资料进行回顾性研究,对比其他区域统计数据,并结合国内外进展,以期对同行处理高坠死亡案件有所帮助。方法对上海市徐汇区2005-2013年度发生的391例高坠死亡案件的资料进行分项统计分析。结果 391例高坠中自杀案例占了多数(82.6%),意外案例占了少数(17.4%),在意外高坠中男性占了多数(86.3%),并且随着年龄的上升,自杀的比例逐渐上升,意外的比例逐渐下降。意外案件的坠落高度可高可低,但总体高度较低,自杀案件的坠落高度一般较高。意外案件中头部着地的比例较高(56.3%)。结论本区目前高坠案件勘验工作仍有不足,运用CT进行虚拟解剖,数字人体模型进行现场模拟等方法是未来的发展方向。     

高坠落水死亡法医病理学研究(附4例报告)

高坠落地死亡的病案报告多见，损伤的成因、特点研究较为成熟，损伤严重程度主要与坠落高度、身体触地部位以及地面性状等因素有关。但自高处坠落入水死亡的病理学特点国内法医学文献未见报告，对此类特殊高坠的病理学特点，包括损伤程度与坠落高度、入水体位、水的深度以及死亡性质等等均有待进一步研究。本文复习有关国外文献报告，结合4例高坠入水尸解发现，对高处坠落入水死亡尸体的病理特点进行分析。     

高坠落水死亡法医病理学研究(附4例报告)

高坠落地死亡的病案报告多见,损伤的成因、特点研究较为成熟,损伤严重程度主要与坠落高度、身体触地部位以及地面性状等因素有关。但自高处坠落入水死亡的病理学特点国内法医学文献未见报告,对此类特殊高坠的病理学特点,包括损伤程度与坠落高度、入水体位、水的深度以及死亡性质等等均有待进一步研究。本文复习有关国外文献报告,结合4例高坠入水尸解发现,对高处坠落入水死亡尸体的病理特点进行分析。案　例【案例1】　某女,2 9岁。某年7月15日自10m高桥上跳入河中,被旁观者救起,送往医院抢救无效死亡。尸解发现:死者身长15 5cm。尸斑在背侧,…     

134例高坠死亡案件鉴定分析

近年来,随着建筑业的发展及社会、生活压力增加,坠落伤的发生率呈明显上升趋势.死亡性质以自杀、意外多见,他杀较少,但部分尸体发现后无法确定死亡方式[1-4],由此引发死亡性质的争论,或对死亡方式、死亡性质的鉴定产生偏差[1-2].本文结合实际案例,对高坠案件死亡方式进行分析,为法医学实践提供参考.     

浅析“高坠”案件现场勘查工作重点

“高坠”案件有逐年增长的趋势，以我区为例，2006年“高坠”案件占人员伤亡案件总数的31％；无论“高坠”行为是自杀还是他杀，其在尸体上反映出来的总体损伤并无差异。要确定案件性质仅仅依靠法医尸体检验较难解决。因种种原因死者家属多不能接受发生的事实，加之有些现象不能完全通过法医学进行很好的解答，不能给死者家属一个完全合情合理的解释，使得此类案件上访数呈上升的趋势。笔者通过查询相关资料以及在案件勘查中的实践，对“高坠”案件现场勘查的重点提出一些想法和建议。     

12例高坠伤致残的法医学鉴定

1995年1月至1996年12月本室共受理12例涉及高坠伤的案件，笔者现对此12例案件进行统计分析，旨在探讨高坠伤致伤规津和损伤特点及其法医学评定在人身损害赔偿案件中的作用。一般资料本组案例中男性11例，女性1例，男女比例为11；l。年龄在2—65岁不等．10岁以下为2例，青壮年7例，50岁以上为3例。损伤环境：建筑施工5例．房顶、窗台3例，梯类2例．其他2例。坠落高度1．5一7米不等．1．5一2米为3例，3一4米为7例．6一7米为2例。坠落面状态：水泥地面8例，沙土类地面3例．水面1例。致伤部位：以头部最多（8例），脊柱和脊髓损伤2例，内脏损伤1…     

浅谈高坠案的现场勘查与法医学检验鉴定要点

高坠案是司法实践检案最常见的类型之一.高坠案的性质有他杀、自杀和意外,多见于后两者.但受高坠案发的突然性、现场多无人在场、很少有可靠的痕迹物证等客观条件限制,使得高坠案的性质判断极其困难.以基层司法实践检案研究为背景,从对高坠现场的坠落起点、坠落空间、水平移行距离、坠落终点进行客观仔细的勘查,全面系统的法医检验鉴定,深入详细的调查走访等多个方面进行全面的阐述和介绍.     

Quasi-static and dynamic bending stress of the pediatric femur for producing a femoral fracture

At the Institute of Forensic Medicine of the University of Heidelberg, in the years 1986-1988 thigh loading tests were conducted in order to produce fractures in a total of 28 cadavers of babies and children who had died at ages ranging from 1 day to 6 years. In 18 tests a universal strength testing machine was used and each thigh was loaded quasi-statically from the outside with a blunt edge applied to the middle of the femur, bending it to the point of fracture. The loading velocity amounted 50 mm/min with a defined support distance. The breakage load amounted to 470 N in a 6-day-old baby and increased about evenly up to 2920 N in a 6-year-old child; however, in a newborn 2720 N was needed and in a 15-month-old child, 5700 N. The total deformation way ranged from 16 to 60 mm. The main types of fracture that occurred were: complete and incomplete transverse fractures, oblique fractures, Messerer fractures, and spongiosa fractures. Ten children ranging in age from 2 months up to 27 months were submitted to dynamical thigh loading by means of a failing weight impactor and a horizontal impactor. Only in one case did a transverse fracture occur, when the lateral thigh impacted on an edge at a falling height of 70-93 cm. The forces set up amounted to 320-600 N with the falling weight impactor and to 2370 N with the horizontal impactor. These results suggest that fracture of the femur does not occur if a baby or small child falls from a changing table or from an adult's arm.     

Fatal falls from a height: two case studies

Two case studies are presented involving fatal falls of adult females from a height. One involved a launch at low speed from a balcony, and one involved a launch at high speed from the top of a cliff. Crime scene evidence obtained on the balcony itself provided a strong indication of homicide, but subsequent investigation showed that the fall was accidental. No crime scene evidence was obtained for the cliff fall since the fall initially appeared to be just another suicide from a popular suicide spot. Subsequent investigations indicated homicide based on measurements of cliff height, horizontal distance to the impact, and available runup distance, plus measurements of possible run, jump, and throw speeds. It was found that a female weighing 61 kg (134 lb) can be thrown at speeds up to 4.85 m/s by a strong male, more than enough to account for the estimated launch speed (4.5 m/s). Given the available 4.0 m runup distance, it was found that women of better than average rather than elite athletic ability can dive at speeds of about 3.5 m/s or jump feet first at speeds of about 4.0 m/s, both being less than the estimated launch speed. The decedent had no athletic ability and landed head first after falling through a height of 29 m.     

不同年龄组颅脑损伤CT扫描分析

本文对520例不同年龄组的颅脑损伤CT片进行了观察分析，表明青少年损伤原因以高坠多见，损伤类型以颅骨凹陷骨折及硬膜外血肿多见，老年组损伤原因以头部击伤多见，损伤类型以颅骨骨折、硬膜下血肿、脑多发性挫裂伤及脑多发性血肿多见，成年组介于两者之间。     

Effect of Wind on Horizontal Displacement of Fatal Fall from a Height

The horizontal displacement of the human body resulting from fatal fall from a height is an important variable commonly used to inversely determine the cause or identify other forensic aspects of the fall. When examining the horizontal displacement, the wind effect is generally ignored. This technical note reports analytical modeling of the falling process, utilizing previous measurements of wind force acting on the human body, for determining the functional relationship between the wind speed and the horizontal displacement in the falling process. The result reveals that it does not take extremely rare wind conditions to cause a considerable shift of the human body, highlighting the importance to consider wind as a factor in investigations of fatal falls.     

Pathologic features of fatal falls from height

Deaths due to falls from height are common in urban settings. At the time the body is found, it is often unclear whether the mode of death is accident, suicide, or homicide. To assess the injury pattern in fatal falls from height with special regard to criteria that might be helpful in discrimination between accident, suicide, and homicide, respectively, we reviewed 68 medicolegal autopsy cases (22 females, 46 males, age range 13-89 years) of fatal falls from height regarding demographic data, findings at the death scene, results of the postmortem examination, psychiatric history, and toxicologic findings. Among the 68 cases, there were 34 suicides, 23 accidents, and 11 unclarified cases, in 3 of which homicide was suspected. In general, suicides were from greater heights than accidents (mean height 22.7 m for suicides and 10.8 m for accidents, respectively; 79% of suicides from more than 16 m). Strikingly, severe head injuries predominantly occurred in falls from heights below 10 m (84%) and above 25 m (90%), whereas in the group of falls from 10 to 25 m, these lesions were seen less frequently (28%). Neck injuries like muscle bleeds and fractures of the hyoid bone were found in 33% of falls from more than 10 m and did not occur from less than 10 m. Our data stress that the evaluation of pathologic features alone is not sufficient to assess the mode of death in fatal falls from height. Instead, postmortem findings have to be considered within the framework of the subject's social, medical, and psychiatric history in conjunction with findings at the death scene and toxicology results to obtain the clearest possible picture of the circumstances of death.     

Skeletal Trauma Resulting From Fatal Low (≤3 m) Free Falls: An Analysis of Fracture Patterns and Morphologies

The skeletal trauma resulting from fatal low (≤3 m) free falls is poorly researched and understood by forensic practitioners. The aim of this study was to identify the types of skeletal trauma resulting from low falls through investigating fracture patterns and morphologies. Skeletal trauma was analyzed using full‐body postmortem computed tomography scans of 145 individuals who died from a low free fall. Trauma was then contextualized to the variables that influence how a person falls using multiple logistic regression. Results showed fracture patterning primarily involved the axial skeleton and that there were a number of patterns significantly associated with the height fallen, pre‐existing health conditions, and age. Analysis of fracture morphologies showed 108 possible fracture types, six of which were significantly associated with the height fallen. Understanding the skeletal trauma characteristic of low free falls will further inform anthropological interpretations of trauma in cases where a fall may be considered the possible mechanism.     

Biomechanical fragility of the infant skull

Following previous experiments on postmortem skull fractures of infants, falls from 82-cm heights onto stone (A), carpet (B) and foam-backed linoleum (C), 35 further falling tests were carried out onto softly cushioned ground. In 10 cases a 2-cm thick foam rubber mat (D) was chosen and in 25 further cases a double-folded (8-cm-thick) camel hair blanket (E). Hence the results of altogether 50 tests could be evaluated. In test groups A-C on a relatively hard surface, skull fractures of the parietale were observed in every case; in test group D this fracture was seen in one case and in test group E in four cases. Measurements along the fracture fissures showed bone thickness of 0.1-0.4 mm. The fracture injuries originated in paper-thin single-layer bone areas without diploe, which can also be considered the preferred regions for skull fractures of older infants following falls from low heights. These results indicate that it is no longer possible to assume that the skull of infants is not damaged after falls from table height.     

意外摔跌致颅脑损伤21例尸体检验分析

通过对21例意外摔跌伤所致颅脑损伤的法医学检验资料进行统计分析,探讨意外摔跌伤的损伤特点、发生原因,以及与高处跌倒、交通事故及打斗中摔跌形成的损伤特点进行比较。结果表明意外摔跌饬有其独特的特点。     

Gunpowder particles as a factor in a gunshot from up close

Existence of different opinions on the role of gunpowder particles in determining close shot distance promoted the experiments with pistol "PM" and sporting fowling piece in vertical and horizontal directions at different distances from 0.5 up to 2.5 m using targets made of pasteboard and moistened photographic paper. The quantities of gunpowder particles on the targets which were calculated by stereoscopic microscope increased distinctly in vertical shot direction (from above downwards), especially at distances 2 and 2.5 m and particle flight distance rose; in horizontal shot direction distances of gunpowder particle flight didn't exceed 2-3 m.