Ötzi the Iceman: forensic 3D reconstructions of a 5300-year-ago murder case

The cause of death of & Ouml;tzi the Iceman has been the subject of extensive investigation. A deep wound on his left shoulder and an arrowhead lodged between his rib cage and left scapula have been central to determining his final moments. While initial CT analyses concluded that exsanguination due to a lacerated left subclavian artery was the cause of death, recent research has suggested that the injury might not have been immediately fatal. This study re-analyzed the 2013 CT scans using a forensic approach to assess the shoulder injury in greater detail, by creating 3D models of the affected anatomical structures and calculating relevant tissue volumes. Additionally, forensic animation techniques were applied to reconstruct & Ouml;tzi's likely posture at the moment of impact. A previously unidentified hematoma with an approximate volume of 110 mL was observed, suggesting that death from blood loss alone may not have been immediate, although external hemorrhage cannot be excluded. Furthermore, forensic animation demonstrated that a straight trajectory of the arrow aligns with both the scapular lesion and arterial laceration, providing new insights into the injury mechanism. These results underscore the value of 3D segmentation and modeling in forensic pathology, offering enhanced reconstructions of traumatic events in both contemporary and archaeological contexts.