Differentiating the injuries exclusively due to falls from a height is difficult if no proper history is provided. Some clinical studies and case reports have been published on the subject, but an autopsy-based approach to the subject is missing in the literature of recent decades. A retrospective study was carried out on 80 cases of fatal falls from a height brought for autopsy. In selected instances police reports, suicide notes, medical records and scene photographs were reviewed. The principal aim was to look for a pattern of skeletal injuries formed as a result of falls from a height.

The majority of the victims were male, aged between 20-30 years and labourers by occupation. Most of them fell from a height of 0-10 feet. The head is the most vulnerable structure with fractures of the vertex being common. As the height of falls increases, fractures of the ribs and sternum are also found. Finally, it is concluded that falls on the head are more likely and the most fatal of all. However, it cannot be taken as a sole indicator of the manner of death. Risk assessment should be carried out before any work at a height is undertaken.