FACT OF IDENTIFYING A NON-LIFE-THREATENING PEDESTRIAN INJURY DURING A FORENSIC MEDICAL EXAMINATION

Abstract

The forensic aspects of low-energy pedestrian injury have not been adequately studied yet. The objective of the study presented is to analyze forensic criteria for identifying the mechanism of injury in low-energy fractures of the lower extremities. The study material included 347 acts of forensic medical examinations of victims with fractures of the lower extremities performed in the Kharkiv Regional Bureau of Forensic Medical Examination for the period from February to June 2018. The selection of forensic medical evaluation reports was carried out at random. The methodology included retrospective analysis, descriptive statistics. The incidence of low-energy pedestrian injury was 0.9%. This type of road traffic injury was registered in people aged 78 – 88 as a result of an alleged collision with the back of a vehicle. The main difference between high- and low-energy fractures of the long bones of the lower extremities was the severity of concomitant injuries (given the fact that closed isolated fractures of the long bones of the lower extremities in our material were accompanied by injuries of the integumentary system (abrasions, bruises, etc.), those fractures were regarded as concomitant injury. In the first case, the action of kinetic energy of significant force led to the formation of multiple fractures of the upper (94; 27.1%) and lower (421; 121.3%) limbs, pelvic girdle (83; 23.9%); concomitant injuries were characterized by the presence of moderate brain concussion (54; 15.6%), non-penetrating blunt chest trauma (102; 29.4%) with rib fractures (48; 13.8%), non-penetrating blunt abdominal trauma (51; 14.7%); all the victims had bruised and lacerated wounds, multiple abrasions, subcutaneous hematomas of various localization. Low-energy trauma was characterized by the presence of isolated fractures of the proximal femur (n = 4) and tibia (n = 3) bones (Table 2). As a concomitant trauma, damage to the integumentary system was recorded in the form of abrasions and subcutaneous hematomas in the fractured area when falling from a height of one's own height (n = 3). In terms of the strength and speed of the impact of the traumatic force, the low-energy pedestrian injury was identical to the fall of the victim from his own height onto the lateral surface of the body with the formation of bodily injuries as closed fractures of the proximal femur. The cause and mechanism of these injuries have not been identified due to the late primary forensic medical evaluation, incomplete data in the medical records on the clinical signs of traumatic injuries to the skin of the victims during the initial examination, inconclusive results of forensic examinations of clothing and footwear, and uninformative data of a technical examination. During the forensic medical examination of a low-energy pedestrian injury, the identification of traumatic injuries of the skin on the side of the fall and on the contralateral side, the place of the first contact with the car, enables to establish the fact of collision and the duration of the damage.