Non-lethal Injuries Research Articles

A retrospective search of postmortem examination reports indicates that death following chiropractic neck manipulation in Australia appears to be a rare event.

The aim of this study was to review the deaths associated with chiropractic treatment in Australia. The National Coronial Information System (NCIS) was searched for cases in Australia for which chiropractic treatment was determined to have contributed to death. Closed, completed Australian cases between 1 July 2000 and 31 December 2019 were evaluated (approximately 356,000 cases). This revealed only one case in which chiropractic treatment was considered to have contributed to death. The case was that of an adult male who died from a dissected left vertebral artery following chiropractic manipulation for neck pain. In addition, postmortem records at Forensic Science SA (FSSA) were searched for similar cases over the same time period (approximately 30,000 cases). No cases definitely attributable to chiropractic manipulation of the neck were found, but a case with thrombus in the left vertebral artery would not be entirely excluded as being related to chiropractic treatment. Deaths associated with chiropractic manipulation in Australia therefore appear rare. Although there is a reported incidence of stroke associated with vertebrobasilar artery system occlusion following chiropractic manipulation, stroke associated with vertebrobasilar artery occlusion has also been observed following a visit to a primary care physician. This could be explained by vertebrobasilar artery pathology causing neck pain that initiated consultation. Thus, the present study only demonstrates a rare temporal, but not causal, relationship between attending a chiropractor and vertebral artery dissection causing death. Non-lethal injuries were not assessed.

Determination of the Perpetrator-Victim Position in a Case of Severe Traumatic Brain Injury due to a Less-Lethal Weapon Projectile, Based on Brain Injuries

Less-lethal (or non-lethal) weapons cause lethal and non-lethal injuries; this depends on many factors, including the shot distance and the modifications made to the operation of the weapon and the projectiles. This type of weapon has a similar shape to a firearm, shares the same physical and chemical operating principle and uses the combustion of a chemical substance to eject the projectile. In technical terms, the only difference is the projectile. Currently with the changes in weapons and projectiles, it is difficult to make a correlation. Just like lethal firearm projectiles and due to their operation, they leave macroscopic gunshot residues such as powder tattooing or soot deposition, only occasionally a contusion ring. In addition, there is a variety in the appearance of the entrance wounds. Therefore, it is very important to process the scene and carefully dissect the external wound and the surrounding area and, if possible, the recovery of the projectile. We present a case where a non-penetrating superficial injury to the skull produced trauma consistent with a coup contrecoup brain injury, which allows us to identify the perpetrator-victim position.

Simulated fire injury: effects of trunk girdling and partial defoliation on reproductive development of apple trees (Malus domestica)

Fire damage can significantly impact fruit productivity in orchards. However, the effects of nonlethal fire injuries on the reproductive development of apple trees remain poorly understood. To investigate these effects, we implemented three treatments: trunk girdling to simulate fire injury to xylem, defoliation of a third of the canopy (simulated crown fire injury), and a combined treatment (simulated surface fire injury), alongside a control. The experiment was conducted during the 2021–22 growing season using a randomised block design with four biological replicate plots. Girdling was less effective than crown and surface fire treatments in influencing fruit composition during the current growing season, and flowering and fruiting in the following season. The crown and surface fire treatments induced localised detrimental effects on fruit sugar and titratable acidity while stimulating peel blush. Additionally, these treatments led to reduced starch reserves by harvest, which likely disrupted subsequent flowering and crop load near the previously defoliated sections of the canopy. When surface fires damage leaves near the base of the canopy in addition to the trunk, fruit production in the lower part of the canopy is more likely to be compromised in the following season. Crown fires, which cause leaf loss near the apex of the canopy, appear to be particularly detrimental to tree productivity, as the top defoliation treatment impaired carbohydrate reserves in shoot terminals and roots. In conclusion, fire-induced loss of leaf area during fruit growth alters fruit composition in the current growing season and may lead to lower yields in the subsequent season.

Does the injury pattern drive the surgical treatment strategy in multiply injured patients with major fractures?

The timing of definitive surgery in multiple injured patients remains a topic of debate, and multiple concepts have been described. Although these included injury severity as a criterion to decide on the indications for surgery, none of them considered the influence of injury distributions. We analyzed whether injury distribution is associated with certain surgical strategies and related outcomes in a cohort of patients treated according to principles of early and safe fixation strategies. In this retrospective cohort study, multiple injured patients were included if they were primarily admitted to a Level I trauma center, had an Injury Severity Score of ≥16 points, and required surgical intervention for major injuries and fractures. The primary outcome measure was treatment strategy. The treatment strategy was classified according to the timing of definitive surgery after injury: early total care (ETC, <24 hours), safe definitive surgery (SDS, <48 hours), and damage control (DC, >48 hours). Statistics included univariate and multivariate analyses of mortality and the association of injury distributions and surgical tactics. Between January 1, 2016, and December 31, 2022, 1,471 patients were included (mean ± SD age, 55.6 ± 20.4 years; mean Injury Severity Score, 23.1 ± 11.4). The group distribution was as follows: ETC, n = 85 (5.8%); SDS, n = 665 (45.2%); and DC, n = 721 (49.0%); mortality was 22.4% in ETC, 16.1% in SDS, and 39.7% in DC. Severe nonlethal abdominal injuries (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.4-3.5) and spinal injuries (OR, 1.6; 95% CI, 1.2-2.2) were associated with ETC, while multiple extremity injuries were associated with SDS (OR, 1.7; 95% CI, 1.4-2.2). Severe traumatic brain injury was associated with DC (OR, 1.3; 95% CI, 1.1-1.4). When a correction for the severity of head, abdominal, spinal, and extremity injuries, as well as differences in the values of admission pathophysiologic parameters were undertaken, the mortality was 30% lower in the SDS group when compared with the DC group (OR, 0.3; 95% CI, 0.2-0.4). Major spinal injuries and certain abdominal injuries, if identified as nonlethal, trigger definitive surgeries in the initial setting. In contrast, severe TBI was associated with delayed fracture care. Patients with major fractures and other injuries were treated by SDS (definitive care, <48 hours) when the pathophysiological response was adequate. The choice of a favorable surgical treatment appears to depend on injury patterns and physiological patient responses. Therapeutic/Care Management; Level IV.

Firearm injuries in Missouri.

Firearm deaths continue to be a major public health problem, but the number of non-fatal firearm injuries and the characteristics of patients and injuries is not well known. The American College of Surgeons Committee on Trauma, with support from the National Collaborative on Gun Violence Research, leveraged an existing data system to capture lethal and non-lethal injuries, including patients treated and discharged from the emergency department and collect additional data on firearm injuries that present to trauma centers. In 2020, Missouri had the 4th highest firearm mortality rate in the country at 23.75/100,000 population compared to 13.58/100,000 for the US overall. We examined the characteristics of patients from Missouri with firearm injuries in this cross-sectional study. Of the overall 17,395 patients, 1,336 (7.7%) were treated at one of the 11 participating trauma centers in Missouri during the 12-month study period. Patients were mostly male and much more likely to be Black and uninsured than residents in the state as a whole. Nearly three-fourths of the injuries were due to assaults, and overall 7.7% died. Few patients received post-discharge services.

Trends in assault-related hospitalizations during the SARS-CoV-2 pandemic

Trends in assault-related hospitalizations during the SARS-CoV-2 pandemic

The Microwave Auditory Effect

The microwave auditory effect has been widely recognized as one of the most interesting and significant biological phenomena from microwave exposure. The hearing of pulsed microwaves is a unique exception to sound waves encountered in human auditory perception. The hearing of microwave pulses involves electromagnetic waves. This paper reviews the research in humans and animals leading to scientific documentations that absorption of a single microwave pulse impinging on the head may be perceived as an acoustic zip, click, or knocking sound. A train of microwave pulses may be sensed as buzz, chirp, or tune by humans. It describes neurophysiological, psychophysical, and behavioral observations from laboratory studies involving humans and animals. Mechanistic studies show that the microwave pulse, upon absorption by tissues in the head, launches a pressure wave that travels by bone conduction to the inner ear, where it activates the cochlear receptors via the same process involved for normal sound hearing. Depending on the impinging microwave pulse powers, the level of induced sound pressure could be considerably above the threshold of auditory perception to cause tissue injury. The microwave auditory effects and associated pressures could potentially render damage to brain tissue to cause lethal or nonlethal injuries.

Low-Cost Forensics Reveal High Rates of Non-lethal Snaring and Shotgun Injuries in Zambia's Large Carnivores

The impact of snaring and human-wildlife conflict (HWC) on large carnivore populations is of growing concern, and yet few empirical data are available. Mortality is the metric most often used, but non-lethal injuries that impact fitness are also important threats. However, because non-lethal injuries to wild carnivores are difficult to detect, they have received little study. Using straightforward forensic examination of the skulls of trophy-hunted lions and leopards from Luangwa Valley (LV) and Greater Kafue Ecosystem (GKE), Zambia, we identified non-lethal injuries consisting of snare damage to teeth and shotgun pellets in skulls. Wire snare entanglement can cause permanent, diagnostic damage to carnivore teeth when individuals bite and pull on the wire. Shotguns are used by poachers, as well as during HWCs to drive off carnivores perceived as threats. Carnivores struck by shotgun pellets can suffer non-lethal, but potentially toxic injuries such as pellets embedded in their skulls. Because poaching and HWC are generally more prevalent near human settlements, we predicted a higher incidence of anthropogenic injuries to carnivores in Luangwa where the human population is larger and more concentrated along protected area edges than Kafue. Contrary to expectation, anthropogenic injuries were more prevalent among lions and leopards in Kafue than Luangwa. Notably, definitive evidence of snare entanglement greatly surpassed previous estimates for these regions. Overall, 37% (41 in 112) of adult male lions (29% in Luangwa, 45% in Kafue) and 22% (10 in 45) of adult male leopards (17% in Luangwa, 26% in Kafue) examined had survived being snared at some point in their lifetime. Among adult male lions, 27% (30 in 112) had old shotgun pellet injuries to their skulls. Our procedure of forensic examination of carnivore skulls and teeth, some of which can be applied to live-captured animals, allows for improved detection of cryptic, non-lethal anthropogenic injuries. Further, our methods represent a consistent and economical way to track changes in the frequency of such injuries over time and between regions, thereby providing a direct measure of the effectiveness of conservation programs that seek to reduce poaching and HWC.

Forensic determination of shark species as predators and scavengers of sea turtles in Florida and Alabama, USA

Sharks are the primary predator of large immature and mature sea turtles, yet the shark species responsible for both lethal and non-lethal injuries are rarely identified. Forensic analysis of bite wounds can be used to accurately assess size and potential shark species when combined with observations on species-specific feeding behavior, geographic distribution, and habitat preference. The objective of this study was to use forensic analysis of bite damage on sea turtles to infer shark size and species. Photographs from 13 cases of documented shark predation (n = 10) and scavenging (n = 3) attempts on sea turtles were retrospectively analyzed, including nesting, free-ranging, and/or dead stranded loggerhead Caretta caretta, green Chelonia mydas, Kemp’s ridley Lepidochelys kempii, and leatherback Dermochelys coriacea sea turtles in Florida and Alabama, USA, from 2010-2020. Mean interdental distance (IDD) and bite circumference (BC) of wound marks on sea turtles suggest that wounds were generated by white sharks Carcharodon carcharias in 3 cases, tiger sharks Galeocerdo cuvier in 3 cases, and bull shark(s) Carcharhinus leucas in one case. For 3 cases with less distinct wound patterns, 2 likely shark species were identified and thereafter narrowed down to a single species based on bite mark characteristics (e.g. punctures). Due to indistinct IDD and BC ranges of the bite patterns, a single shark species was not identified in 3 cases. Forensic analysis enables more accurate evaluations of which shark species prey on and scavenge sea turtles and is a useful technique for studying the behavioral interactions of sharks and turtles.

FORENSIC MEDICAL ASSESSMENT OF INJURY SEVERITY OF LARYNX AND HYOID BONE BASED ON PRE-JUDICIAL AND JUDICIAL INVESTIGATION

Victims with fatal and non-fatal closed blunt trauma of the larynx and hyoid bone often become the object of forensic medical service during the pre-judicial and judicial investigation. The purpose of this study is to analyze the features of expert qualification of bodily injuries in victims with closed blunt trauma of the larynx and hyoid bone, depending on the nature and severity to determine ways to unify its forensic diagnosis. Materials and methods. The study was based on the conclusions of 35 forensic medical examinations of cases of closed blunt trauma of the larynx and hyoid bone, obtained from the leading expert institution of the Kharkiv region. Results. We determined the peculiarities of estimating the degrees of severity of above bodily injuries. Severe injuries were found in 12 (34.4%) cases of death of the victims from mechanical asphyxia, in one case of reflex cardiac arrest, and in one case of traumatic shock. Injuries of moderate severity were established by experts in 6 (17.1%) cases of lethal and in 6 (17.1%) cases of non-lethal cases with laryngeal cartilage fractures; in 2 (6.2%) cases of non-lethal injuries with acute oedema, hematoma, laryngeal stenosis of the second degree. 7 (20%) cases of non-lethal laryngeal injuries with further development of acute posttraumatic laryngitis were qualified as simple injuries. Conclusion. There are no clear morphoclinical criteria for objective assessment of injuries of the larynx and hyoid bone that can lead to pre-diagnostic expert errors. According to the results of the work, the ways to unify forensic medical assessment and diagnosis of such injury was determined.

The gunshot-related injuries in trauma (GRIT) study: A profile of patients affected by gunshot-related orthopaedic injuries across South Africa.

South Africa (SA) has one of the highest gun-related mortality rates in the world - 20 people per day. The available data, however, do not reflect the substantial number of patients suffering non-lethal firearm injuries. Gunshot-related injury has been recognised as a highly costly healthcare problem by individual treating centres in SA and other countries; however, no 'national picture' has been examined in detail. To explore the burden of gunshot-related orthopaedic injuries across SA. A multicentre research network was established in SA, and 37 orthopaedic units across 9 provinces participated. A prospective, observational cohort study was performed during a 2-week period in 2019. Patients were screened, enrolled and reported by local orthopaedic teams. Patients were included if they had at least one acute gunshot-related orthopaedic fracture referred to the orthopaedic service. Patients were asked additional questions around baseline health-related quality-of-life (HRQOL) and personal circumstances. Follow-up was at 8 weeks after injury. Thirty-seven centres enrolled 135 patients over the 2-week study period. Western Cape Province had the highest number of reported cases (n=52; 39%), followed by Gauteng (n=35; 26%) and KwaZulu-Natal (n=29; 21%). The median age of patients was 30.5 years and the majority were male (89%). Forty-three percent of patients had been either shot or stabbed prior to this injury. Fifty-two percent of all patients required fracture fixation surgery and 11% required wound debridement without fracture fixation. HRQOL data were collected successfully at baseline, but follow-up data were available for &lt;25% of cases. Gunshot-related orthopaedic injuries represent a significant burden of disease in the SA healthcare environment. This study highlights several areas for further research in the management of the injuries and associated outcomes.

Heart Regeneration in the Leopard Gecko ( Eublepharis macularius ): a Comparison of Spontaneous Repair and Regrowth Following Two Different Injury Models

Across vertebrates, non-lethal injuries to the heart are resolved in one of two ways: scar formation or regeneration. Injury to the mammalian heart results in the permanent loss of contractile muscle cells (cardiomyocytes) and formation of a non-contractile fibrous scar. In contrast, species such as zebrafish and salamander are capable regenerating damaged or lost cardiomyocytes, thus restoring heart function. Previous work has shown that the cellular processes involved in heart regeneration, such as cell death and proliferation, appear to be conserved across teleost fish and salamanders. Whether similar the cellular processes are involved in heart regeneration in reptiles remains largely unexplored. Here, we characterize heart regeneration in the lizard Eublepharis macularius (the leopard gecko, hereafter ‘gecko’), following two different injury models: a physical puncture (cardiocentesis) and a cryolesion. Cardiocentesis is a penetrating wound that creates a small-scale lesion as a needle passed through the body wall into the heart ventricle. A cryolesion requires opening the body cavity to expose the heart, and then placing a pre-cooled probe directly on the ventricle. This results in the destruction of ~30% of the ventricle. Both injury models were tolerated by geckos, and normal movement and feeding behaviours were resumed within days. To characterize the cellular events involved in heart repair, we used serial histology and immunostaining for markers of cell death (Terminal deoxynucleotidyl transferase dUTP nick end labeling) or cell proliferation (proliferating cell nuclear antigen), each with markers for cardiomyocytes (alpha-smooth muscle actin, myosin heavy chain), and fibroblasts/endocardial cells (Vimentin). Within the first 1-3 days, both injury models are characterized by localized cell death and a loss in cardiomyocytes at the wound site. Over the next two weeks, injured hearts no longer show evidence of cell death. Simultaneously, there is an increase in cell proliferation by populations of cardiomyocytes bordering the wound site and by non-cardiomyocytes within the wound bed itself. Cardiocentesis injuries were resolved within 14 days, while cryoinjuries were resolved within 60 days. Ultimately, both injury models demonstrate the return of mature cardiomyocytes and the near-perfect restoration of the original architecture of the ventricular wall. Overall, our findings reveal that the cellular responses involved in gecko heart regeneration are conserved across different injury models but the duration of repair varies with the magnitude of the injury.

Associations between state intimate partner violence-related firearm policies and injuries among women and men who experience intimate partner violence

BackgroundComprehensive state firearm policies related to intimate partner violence (IPV) may have a significant public health impact on non-lethal IPV-related injuries. Research indicates that more restrictive firearm policies may reduce risk for intimate partner homicide, however it is unclear whether firearm policies prevent or reduce the risk of non-lethal IPV-related injuries. This study sought to examine associations between state-level policies and injuries among U.S. IPV survivors.MethodsIndividual-level data were drawn from the National Intimate Partner and Sexual Violence Survey, a nationally-representative study of noninstitutionalized adults. State-level data were drawn from a firearm policy compendium. Multivariable regressions were used to test associations of individual policies with non-fatal IPV-related injuries (N = 5493). Regression models were also conducted to explore differences in the policy-injury associations among women and men survivors.ResultsThree categories of policies were associated with IPV-related injuries. The odds of injuries was lower for IPV survivors living in states that prohibited firearm possession and require firearm relinquishment among persons convicted of IPV-related misdemeanors (aOR [95% CI] = .76 [.59, .97]); prohibited firearm possession and require firearm relinquishment among persons subject to IPV-related restraining orders (aOR [95% CI] = .81 [.66, .98]); and prohibited firearm possession among convicted of stalking (aOR [95% CI] = .82 [.68, .98]) than IPV survivors living in states without these policies. There was a significant difference between women and men survivors in the association between IPV-related misdemeanors policy and injuries (B [SE] = .60 [.29]), such that the association was stronger for men survivors (aOR [95% CI] = .10 [.06, .17]) than women survivors (aOR [95% CI] = .60 [.48, .76]).ConclusionsRestrictive state firearm policies regarding IPV may provide unique opportunities to protect IPV survivors from injuries.

Fitness Implications of Nonlethal Injuries in Scorpions: Females, but Not Males, Pay Reproductive Costs.

AbstractThe ability to detach a body part in response to a predation attempt is known as autotomy, and it is perhaps the most intensively studied form of nonlethal injury in animals. Although autotomy enhances survival, it may impose reproductive costs on both males and females. We experimentally investigated how autotomy affects the reproductive success of males and females of a scorpion species. Individuals of Ananteris balzani autotomize the last abdominal segments (the tail), losing the anus and leading to lifelong constipation, since regeneration does not occur. Although the male tail is used during courtship and sperm transfer, autotomy has no effect on male mating success. The combined effect of increased mortality and reduced fecundity resulted in autotomized females producing nearly 35% fewer offspring than intact females. In conclusion, the negative effects of tail autotomy are clearly sex dependent, probably because the factors that influence reproductive success in males and females are markedly different.

Positioning public health surveillance for observational studies and clinical trials: The St. Louis region-wide hospital-based violence intervention program data repository

Positioning public health surveillance for observational studies and clinical trials: The St. Louis region-wide hospital-based violence intervention program data repository

The Young Lives Matter study protocol: A case-control study of the determinants of suicide attempts in young people in India

Suicide is the second leading cause of death among young people in India. Over 40% of all suicides occur in people between 15 and 29 years of age. Suicide attempts are estimated to be 15 times more common than suicides and substantially increase the risk of subsequent death. However, there has been little systematic study of the determinants for suicide attempts in young people, which makes it difficult to design contextually appropriate and comprehensive suicide prevention strategies for this population. The proposed case-control study seeks to address this knowledge gap by studying a range of risk and protective factors for suicide attempts in young people in India. Field work will be in Yashwantrao Chavan Memorial Hospital (YCMH) hospital, in Pimpri-Chinchwad, Pune, India. Cases will be 15-29-year-old individuals admitted to the hospital with self-inflicted non-lethal injuries and poisoning. They will be matched for age and gender with those presenting at the General Medicine outpatient department with other health complaints. In each group, 150 persons will be recruited from YCMH from October 2019 to September 2022 and will undergo a comprehensive semi-structured interview. The primary exposure variable is negative life events over the past 12 months. Secondary exposure variables considered include: demographic characteristics, psychological factors, addictive behaviours, personal resources, adverse experiences over their lifetime, social support, suicidal behaviours in the family and social environment, and exposure to suicide-related information. Data will be analysed using conditional logistic regression. Following completion of the study, workshops will be held with young people, mental health professionals and policy makers to develop a theory of change that will be used to promote suicide prevention. Results will be disseminated via peer-reviewed publications, reports to young people and mental health organisations, and news articles. The study was approved by the Institutional Review Board at Sangath.

The Young Lives Matter study protocol: A case-control study of the determinants of suicide attempts in young people in India.

Suicide is the second leading cause of death among young people in India. Over 40% of all suicides occur in people between 15 and 29 years of age. Suicide attempts are estimated to be 15 times more common than suicides and substantially increase the risk of subsequent death. However, there has been little systematic study of the determinants for suicide attempts in young people, which makes it difficult to design contextually appropriate and comprehensive suicide prevention strategies for this population. The proposed case-control study seeks to address this knowledge gap by studying a range of risk and protective factors for suicide attempts in young people in India. Field work will be in Yashwantrao Chavan Memorial Hospital (YCMH) hospital, in Pimpri-Chinchwad, Pune, India. Cases will be 15-29-year-old individuals admitted to the hospital with self-inflicted non-lethal injuries and poisoning. They will be matched for age and gender with those presenting at the General Medicine outpatient department with other health complaints. In each group, 150 persons will be recruited from YCMH from October 2019 to September 2022 and will undergo a comprehensive semi-structured interview. The primary exposure variable is negative life events over the past 12 months. Secondary exposure variables considered include: demographic characteristics, psychological factors, addictive behaviours, personal resources, adverse experiences over their lifetime, social support, suicidal behaviours in the family and social environment, and exposure to suicide-related information. Data will be analysed using conditional logistic regression. Following completion of the study, workshops will be held with young people, mental health professionals and policy makers to develop a theory of change that will be used to promote suicide prevention. Results will be disseminated via peer-reviewed publications, reports to young people and mental health organisations, and news articles. The study was approved by the Institutional Review Board at Sangath.

345EMF Positioning Public Health Surveillance for Observational Studies: The St. Louis Hospital-Based Violence Intervention Program Data Repository

345EMF Positioning Public Health Surveillance for Observational Studies: The St. Louis Hospital-Based Violence Intervention Program Data Repository

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.

Structure of long bone fractures of lower limbs at a car injury

The most traumatized body region in road traffic accidents is the lower extremities, however, the structure of fractures has not been adequately studied. Objective: to study the structure of long bones fractures of the lower extremities in various nonlethal car injuries. Material and methods. The research material was 116 reports of primary forensic medical examinations of victims with fractures of the femur and/or shin bones resulting from a car injury. When studying the frequency of damage to various areas of the body and the frequency of fractures of long bones of the lower extremities, it was taken into account that 28 victims with polytrauma had multiple injuries, and thus 116 patients revealed 232 injuries of various areas of the body and 138 fractures of long bones of the lower legs. Research methods — retrospective analysis, descriptive statistics. Results. The main contingent of those injuries in the car accident was car drivers (8.5%) and pedestrians (47.3 %) aged 31–50 years. In the general group, the shin (37.9 %), thigh (21.6 %), head (13.8 %) were most injured areas, in the group of car drivers — neck, thigh, chest, shin, in the group of passengers — head, shin and thigh; pedestrians — shin, thigh, head. Due to the predominance of anterior (41.4 %) and anterolateral collisions of a moving car in the group as a whole, in cases of the of pedestrians injuries as well as in cases of in-cabin injuries, the presence of bumper fractures of the lower leg bones, as well as fractures of the femur of various localization, was observed. Conclusions. According to the initial forensic medical examination, a collision of a moving car with a pedestrian (78.4 %) and a collision of moving vehicles (21.6 %) were observed in the structure of non-lethal car accidents. In this case, diaphyseal fractures of the femur (29.8 %) and the shin bones (47.1 %) in the general group and in the group of pedestrians (20.4 and 40.7 %, respectively) predominated. Fractures of the femur of various localization were most often detected also in the in-cabin injuries (50.0 % of the total number of fractures in drivers and passengers).