In forensic routine (poly-) trauma after fall from height is a frequent cause of death, often resulting from either suicide or accidents. Autopsies in these cases establish not only the cause of death but also assist in reconstructing events leading to the impact, including the victim’s position just before hitting the ground [1,2,3,4,5,6,7,8]. Feet-first falls from height with primary impact on the lower extremities lead to significant injuries, including comminuted fractures of the calcaneus (heel bone), tibia, and fibula. The energy transmitted through the legs can also cause injuries to the knees and hips, potentially resulting in fractures or dislocations. Usually, the force from the impact drives bones from the foot into the tibia. The energy from the impact fractures the tibia and usually the fibula [9]. Additionally, the impact leads to soft tissue injuries such as severe contusions, sprains, or tears in ligaments and tendons. The energy may be even sufficient to cause axial loading injuries, leading to vertebral fractures or spinal injuries. The pattern of these injuries can provide critical information about the height of the fall and the position of the individual while hitting the ground which are essential for forensic reconstruction and analysis. The tibia as a weight-bearing bone is susceptible to both diaphyseal (shaft) fractures and intra-articular fractures, particularly at the knee and ankle joints. These injuries can manifest as transverse, oblique, or spiral fractures, depending on the dynamics of the fall and the angle of impact. In addition to fractures, feet-first falls can also result in tibial stress injuries or even tibial plateau fractures.

In the presented case the tibial fractures and their particular appearance indicate the considerable force resulting from the impact along the longitudinal axis of the body, with comminuted fractures at the distal part of the lower limbs and kinetic energy transmitted downwards to the region of the foot, leading to the perforation of the sole of the feet and even the shoes. According to the formula for assessing the speed at the moment of impact, which results from v = √2gh (v = velocity of impact, g = gravitational constant, h = distance), considering a height of between 35 and 40 m, the impact with the ground occurred in this case at a speed of between 26,2 m/s (94,3 km/h) and 28 m/s (100,8 km/h). The kinetic energy that was then transferred to the victim’s body, according to the formula KE = ½ mv2, where v is the velocity at impact and m is the mass of the victim, was thus between 29,744 J and 34,496 J [10,11,12]. Thus, the height of the fall (35–40 m), which resulted in such major injuries, indicating a pattern associated with a feet-first fall and high kinetic energy transmission through a relatively small impact area. Similar injuries have been described in cases of feet-first falls but those found in the presented case provide information about the height of the fall and the respective dynamics. Beyond injuries related to aviation accidents and vehicle collisions [13,14,15,16], fatal falls from heights such as buildings, bridges, rock walls, or cliffs are high-velocity events where the body is subject to extreme decelerative forces.