Abstract
Thoracic transverse process fractures (TTPFs) are injuries that go unnoticed during traditional autopsies, as demonstrated by a lack of medicolegal publications regarding TTPFs. However, postmortem computed tomography (PMCT) has made detection of this type of injury easy. Thus, the goal of our study was to analyze the significance of TTPFs in the context of medicolegal opinions. Forensic autopsy reports and PMCT scans of 116 people who had died from high-energy trauma were analyzed. TTPFs were found in 34.48% (n = 40) of the total test group. The highest proportions of TTPFs were found in drivers (50%, n = 8) and in victims of falls from heights (41%, n = 14). Among seven car passengers, only one victim had suffered TTPFs. In comparison with persons without TTPFs, persons with TTPFs demonstrated more severe general injuries, especially to the chest and abdomen, and more often (in 90% of cases) died at the scene of injury (all these differences were statistically significant; p < 0.0001). Pedestrian TTPFs were present only in victims struck from their front or back. TTPFs in victims of falls were found only in those cases in which the height of the fall was at least 9 m. The presence of TTPFs indicates that the application of a very strong force leads to injuries that, in most cases, result in death at the scene of the event. Detecting TTPFs provides additional information about the mechanism of trauma, especially in pedestrians, drivers, passengers, and victims of falls from heights.
Highlights
In medicolegal practice, determining the cause of death in victims of high-energy trauma is usually not difficult
Apart from a very small number of deaths, whose circumstances were identified as “other”, the highest percentage of thoracic transverse process fractures (TTPFs) cases was found in drivers (50%, n = 8) and in victims of falls from a height (41.17%, n = 14) (Fig. 3)
The majority of persons with TTPFs died at the site of the incident (90%, n = 36), as opposed to those without TTPFs, with 43.42% (n = 33) of the latter subgroup dying at a later time in a hospital
Summary
In medicolegal practice, determining the cause of death in victims of high-energy trauma is usually not difficult. Thanks to the more and more widespread use of postmortem computed tomography (PMCT), it has become possible to diagnose injuries (especially bone injuries) which, until now, had been very easy to overlook during traditional autopsies [1,2,3,4,5,6]. One type of such injuries, which are very difficult—and in many cases, impossible—to detect during a traditional autopsy, are thoracic transverse process fractures (TTPFs). Ventral access to thoracic transverse processes is hindered by
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