Identification Of Traumatic Injury Research Articles

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

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.

Injury Rate of the Bronze Age Population from the Lower Volga Area

Introduction. The research objective is to determine and analyze data on traumatic phenomena found in the bones of the Bronze Age population originating from the burial sites of the Lower Volga area. Methods. The identification of traumatic injuries in anthropological materials was based on the works and recommendations in the field of special traumatology and pathology used in forensic medicine and bioarchaeological reconstructions. Statistical analysis was carried out using one-dimensional methods and nonparametric Mann-Whitney and Kruskal-Wallis criteria. Analysis. The study of paleoanthropological materials of the Early Bronze Age shows that injuries are found only on skulls. The total injuries of the adult population in the group are at the level of 15.2%. Of the 5 injuries on the bones of the Early Bronze Age, 1 belongs to a woman and 4 – to men. Severe injuries are discovered in adult individuals. General injuries are not numerous and reach 24.8%. In the series of the Late Bronze Age, injuries on the bone remains of children are also not detected. The frequency of occurrence of traumatic objects on anthropological materials of II millennium BC is insignificant, only 18 cases, which is 16.1% of the total number of adult individuals. Results. In the studied series, sex dimorphism and differences in the nature of distribution of injuries between groups of different ages are not statistically revealed, which indicates similar social roles of the male and female population in the Bronze Age. No injuries are detected in children. The frequency of perimortem injuries is extremely low. Non-lethal (uniform, with traces of healing) injuries on the skull bones and postcranial skeleton dominate in the series, which indicates a similar level of technological development and medical knowledge in the Bronze Age population. Injuries of the Bronze Age of the Lower Volga region can be described as every day or civilian trauma due to the development of labor production or social tension in the groups.

An evaluation of the relationship between traumatic injuries and the development of contrast-associated acute kidney injury

BackgroundIntravenous contrast media-enhanced computed tomography is vitally important in the early identification of traumatic injuries. Contrast media, however, has the propensity to promote nephrotoxicity. Age, injury severity score, renal dysfunction, and hypotension upon presentation are factors associated with contrast-associated acute kidney injury in current trauma literature. This study endeavors to expand upon these findings and evaluate the relationship between traumatic injuries and contrast-associated acute kidney injury.MethodsThis is a retrospective cohort study conducted at a Level 1 Trauma Center between January 2005 and August 2013. Patients identified by the institution’s Trauma Registry were divided into two groups: contrast-associated acute kidney injury-positive and negative based on previously published definitions.ResultsThe analysis consisted of 831 intensive care patients; 161 contrast-associated acute kidney injury-positive and 670 contrast-associated acute kidney injury-negativ...

Identification of Traumatic Injury in Burned Cranial Bone: An Experimental Approach

Interpreting patterns of injury in victims of fire-related deaths poses challenges for forensic investigators. Determining manner of death (accident, suicide or homicide) using charred remains is compounded by the thermal distortion and fragmentation of soft and skeletal tissues. Heat degrades thin cranial structures and obscures the characteristic signatures of perimortem ballistic, blunt, and sharp force trauma in bone, making differentiation from thermal trauma difficult. This study documents the survivability and features of traumatic injury through all stages of burning for soft tissue reduction and organic degradation of cranial bone. Forty cadaver heads were burned in environments simulating forensic fires. Progression of thermal degradation was photographically documented throughout the destructive stages for soft tissues and bone to establish expected burn sequence patterns for the head. In addition to testing intact vaults, a percentage were selectively traumatized to introduce the variables of soft tissue disruption, fractures, impact marks, and incisions throughout the cremation process. Skeletal materials were recovered, reconstructed, and correlated with photographs to discern burn patterns and survivability of traumatic features. This study produced two important results: (1) Identification of preexistent trauma is possible in reconstructed burned cranial bone. Signatures of ballistic (internal and external bevel, secondary fractures), blunt force (impact site, radiating fractures), and sharp force (incisions, stabs, sectioning) survive the cremation process. (2) In non-traumatized specimens, the skull does not explode from steam pressure but does fragment as a result of external forces (collapsed debris, extinguishment methods) and handling. The features of both results are sequentially described throughout the progression of thermal destruction.