Differentiating fatal one-punch assaults from standing height falls based on skeletal trauma: a pilot study

Abstract

ABSTRACTA fatal one-punch assault is defined as a single punch to a person’s head or neck resulting in death. In some of these assaults, it may be important to understand which injuries stemmed from the punch, the resulting fall, or both. The aim of this study was to identify if there were differences in skull and cervical fractures between deaths from a one-punch, one-punch with fall, and fall from standing height. Relevant cases were extracted from the Victorian Institute of Forensic Medicine’s database, and case circumstances and biological variables were recorded from coronial documentation. Fracture patterns and types were documented from post-mortem computed tomography scans. Trauma was analysed in the context of the variables using descriptive and bivariate models. Six one-punch, 15 one-punch with fall, and 30 standing height fall deaths were included. There were subtle fracture differences. All skull regions fractured in the three events; however, the frequency of fractures varied, and cervical vertebrae fractures did not occur in the isolated one-punch deaths. Variations of linear fractures resulted from falls while linear, diastatic and blowout fractures resulted from a punch. The findings augment the evidence base for trauma interpretations in one-punch assaults and provide the foundation for a large-scale study.