FM7.2 | Fall from Height & Vehicular Injuries — Summary & Reflection

KEY TAKEAWAYS

Falls from height produce injuries determined by landing position: feet-first (calcaneal fractures, lumbar wedge-compression, wrist fractures), head-first (skull/cervical fractures), lateral (hip fractures, thoracic injuries). Vehicular injuries follow a reproducible sequence: bumper fracture (primary impact, height indicates vehicle class) → bonnet injury (secondary) → ground impact (head injury, tertiary). Waddell's triad (lower limb + trunk + head injury) is the pedestrian-vehicle teaching construct. Run-over produces tyre-tread patterned abrasions whose orientation indicates direction of travel; organ bursting from compression is characteristic. Railway spine is neurological injury (cord concussion to laceration) from jarring/jolting forces, without necessarily fracturing the vertebrae — a recognised entity distinct from malingering. Crush syndrome follows prolonged compression: rhabdomyolysis → myoglobinuria → ATN → acute renal failure; hyperkalemia at moment of release is immediately life-threatening. IPC 304A (death by negligence) is the usual charge in road traffic fatalities; IPC 299/300 apply to deliberate vehicular homicide. The Motor Vehicles Act 1988 governs licensing and compensation separately from criminal IPC proceedings.

REFLECT

Consider a scenario where a motorcyclist is struck from behind at high speed on a national highway, thrown 15 metres, and killed instantly from massive head injuries. The lorry driver claims the motorcyclist had no rear lights and swerved unexpectedly. The motorcyclist's family alleges the lorry driver was speeding and drove after the collision without stopping. Your post-mortem report will be central evidence in the Motor Accidents Claims Tribunal and potentially in a criminal court. Reflect on: what specific findings in your post-mortem report would be most useful for reconstruction of events? How would you document the direction and force of impact from the injury pattern? What are the limits of your forensic opinion, and what additional evidence (scene, vehicle examination, CCTV) would be needed to reach a complete medico-legal opinion?