车外人员撞击伤特点分析

目的以真实案例为基础,研究汽车碰撞事故中,不同机动车车型、不同交通方式等因素造成车外人员撞击伤的特征。方法选取上海地区发生的汽车与车外人员碰撞事故案例200例,通过对事故中的人、车等检验对比,分析车外人员撞击伤的特点。结果车外人员撞击伤主要出现在下肢,其次为胸部和头部;行人（含推车人）撞击伤出现频次与骑车人（含自行车或摩托车后座乘员）无明显差异;小轿车和小客车事故中撞击伤多见于下肢,大客车多见于胸部;车外人员被撞击后发生抛甩频率随车速的加大而增高,且通过车体痕迹检验,人体与车辆挡风玻璃发生（二次）撞击伤匹配程度最高。结论分析汽车与车外人员碰撞事故人体撞击伤特点,对于交通伤法医学鉴定及深化交通伤机制研究具有参考价值。     

Analysis of fatal injuries to motorcyclists by helmet type

To clarify the characteristics of injuries of motorcyclists dying in accidents in relation to helmet type, we retrospectively analyzed forensic autopsies of 36 helmeted motorcycle riders. The presence of major injuries and injury severity were evaluated with the injury severity score and the 1990 revision of the Abbreviated Injury Scale. Persons with open-face helmets (19 cases) were significantly more likely to have sustained severe head and neck injuries, especially brain contusions, than were persons with full-face helmets (17 cases). Furthermore, major injuries of the chest or abdomen, rib fractures, lung injuries, and liver injuries were each present in more than one quarter of all cases (26.3% to 70.6%), but their prevalences did not differ significantly between riders with different types of helmet. Because many types of head and neck injuries cannot be prevented and fatal chest and abdominal injuries occur despite the use of full-face helmets, more effective helmets and devices for protecting the chest and abdomen are needed to decrease deaths from motorcycle accidents.     

498例海口市道路交通事故死亡案例的法医学分析

目的分析海口市道路交通事故死亡案件的特点,为死亡原因鉴定及预防提供参考依据。方法收集2014—2016年海口市公安局交警支队受理的498例道路交通事故死亡的案例资料,对性别、年龄、案发时间、死者交通方式、肇事车辆类型及死亡原因等相关参数进行分析。结果死者年龄以21~40岁居多,男女性之比为3∶1;案发时间以每年3、4、5月及10月,每天的6:01~8:00及20:01~22:00为高峰期;死者交通方式以驾(摩托车和电动车)的发生率最高(30.9%);肇事车辆以摩托车和电动车为主(57.4%);死亡原因以颅脑损伤居多,胸腹部损伤次之。结论道路交通事故死亡案件的尸体检验对死亡性质及责任认定有重要作用和意义。     

Traumatic testicular displacement in motorcycle drivers

Testicular displacement is a rare clinical presentation of blunt scrotal injury that may take place in road traffic accidents involving motorcycle occupants. We are presenting two cases of motorcycle occupant fatalities, 21 and 24 years of age, where testicular displacement and other signs of groin trauma have been determined. In both cases, discrete external signs of scrotal trauma were noted on examination, while unilateral and bilateral traumatic testicular displacement, respectively, have been documented at autopsy. For motorcycle occupants involved in collision, it is necessary to perform a thorough analysis of injuries, in particular to look for specific trauma arising from fuel-tank impact to genitalia and/or groin. These injuries are of great medico-legal importance both at postmortem and in clinical cases involving motorcycle occupants involved in collision.     

Injury analyses of fatal motorcycle collisions in south-east Scotland

The timing of death and pathological findings in fatal motorcycle accidents in south-east Scotland between 1987 and 1997 were investigated. Of the 59 motorcyclists who died, 38 were dead when found at the accident scene, six others were alive when found but died at the scene, two died in an ambulance in transit to hospital and 13 died after reaching hospital. Scoring of the injuries according to the Abbreviated Injury Scale revealed Injury Severity Scores (ISS) ranging from 25 to 75. Overall, injuries to the head, neck and chest were responsible for the most severe injuries. Twenty-five motorcyclists had injuries acknowledged to be unsurvivable (ISS = 75), most of which involved the thoracic aorta, brainstem and cervical spinal cord. The greatest potential to reduce the death rate amongst motorcyclists lies with accident prevention/injury reduction measures, rather than through improved treatment of injuries. Efforts to try to alter driving behaviour and to improve the design of vehicles and helmets need to continue.     

Drinking and driving in Singapore, 1987 to 1989.

Between 1987 and 1989 there were approximately 5,000 cases of fatal and injury-sustained road traffic accidents, of which 2.3-3.0% were alcohol related (blood alcohol levels greater than the legal limit of 80 mg% ethanol). The offenders of alcohol-related accidents are mostly Chinese (> 79%), male (> 98%), and more often 30-40 years old. The majority of the alcohol-related accidents (> 74%) took place between 8 P.M. and 4 A.M. in fine weather and light traffic. Rear-end, head-on, and side-on collisions comprised > 60% of all the alcohol-related accidents, and losing control of vehicles approximately 30%. Drunken driving cases for the same period that were not accidents showed a number of characteristics similar to those for accidents. In Singapore, motorcycle riders and pedestrians are more prone to road fatality than other road-user groups. International comparisons of road fatalities per 100,000 population gave Singapore one of the lowest accident rates (8.1-8.4) as compared with countries such as Australia, the United Kingdom, the United States, New Zealand, Canada, and Japan.     

Death by motorcycle: background, behavioral, and situational correlates of fatal motorcycle collisions

Motorcycle fatalities in the United States continue to increase on both crude and adjusted bases. This paper examines fatal motorcycle accidents as a cause of death, using a retrospective analysis of motorcycle operator fatalities from 2003 to 2008 in the state of Indiana. During these six years, out of more than 18,000 motorcycle operators in crashes, 601 were killed. Based on police report data, motorcycle operators during this period are examined to reveal key factors that are in place when a motorcyclist is killed in a collision. The major correlates of death identified were objects of impact, risky behaviors, and speed. The largest positive effects on the chances of death were linked to trees, posts-signs-poles, bridge-guardrail-median, and other motor vehicles. In conjunction with speed, these objects were the primary mechanisms by which fatal injuries were sustained by motorcyclists. Various types of risky behavior were also major correlates of death by motorcycle.     

Identification of the driver in two-rider motorcycle accidents. Inguinal contusion-laceration as an indication of the driver

In motorcycle accidents involving two riders, medicolegal identification of the driver is necessary when one or both riders die. It is particularly important in the latter case, because the survivor almost always insists that he or she was not driving. One characteristic injury that distinguishes the driver from the passenger is inguinal contusion-laceration (accompanied internally by pelvic fracture). This injury, caused by collision of the pelvis with the fuel tank, identifies the driver.     

交通事故中摩托车司乘人员致伤方式分析

通过对3例摩托车交通事故中司乘人员的损伤特征及车辆痕迹的检验结果比对,分析事故过程中摩托车司乘人员的运动过程及致伤方式,发现因其位置、姿势和应激状态不同,摩托车驾驶位乘员与后座乘员在碰撞、运动过程中损伤形成不同,其人体成伤机制、部位及程度与车辆相关部位的损害痕迹可以相互佐证,对于推断摩托车司乘人员的行为方式(谁是摩托车驾驶员)具有重要价值。进一步总结此类事故鉴定的共同特点,可为事故责任认定提供参考。     

90例行人撞击伤案例分析

目的 探讨行人交通事故和致伤车辆类型的关系,总结其规律.方法 回顾90例行人交通事故案例,分析致伤车辆、损伤部位、损伤特点、严重程度之间的关系. 结果 不同类型致伤车辆所致的撞击伤好发部位取决于受撞击时人体的姿势和车头突出部位的高度,其损伤特点与作用力大小、方向和接触面光滑程度相关. 结论 通过对行人撞击伤的损伤部位、损伤特点、严重程度的分析,可以推断致伤车辆类型.     

深圳市道路交通事故死亡案例特点分析

目的探讨道路交通事故死亡案例特点,为预防事故的发生提供可靠信息和参考数据。方法按照死者性别、年龄、死亡原因、事故发生时间及地点、事故车辆类型等相关参数,对深圳市4184例道路交通事故死亡案例进行回顾性分析。结果事故死亡人员以男性为主,男女比例为2.45∶1;事故在6：00～8：00和18：00～2：00发生最多;72%的案例在城郊主干道发生;死者主要交通行为方式分别为步行占44%,自行车骑车人19%,摩托车驾车人15%;肇事车辆以货车为主;死亡原因83.2%为颅脑损伤死亡,13.3%为多发损伤。结论深圳地区道路交通事故死亡案件具有明显特点,具有可防范性。     

Fatal hunting injuries in North Rhine-Westphalia

The investigation covers 14 fatal hunting accidents which occurred in North Rhine-Westphalia in the last 23 years, among them 13 firearm fatalities. All the accidents happened during the statutory hunting season reaching a peak in the main small game season. 86% of the persons causing the accidents and 73% of the victims were over 41 years and experienced hunters. 36% of the accidents were caused by the victims themselves. The fatal gunshot injuries were inflicted by rifle bullets in 7 cases (54%) and shotgun pellets in six cases (46%). No accidents were due to shotgun slugs or handgun ammunition. The main factors responsible for the fatalities were: covering the victim while swinging on the game (31%), failure to discharge the firearm while descending from the raised hide or transporting the weapon in vehicles (31%), mistaking the victim for game (15%), failure to discharge the weapon during a hunting break or while pressing down obstacles or careless handling of the weapon (23%). In no case was the accident caused by a defective weapon or ammunition. In conclusion aspects of preventing fatal hunting accidents are discussed.     

Fatal motorcycle accidents in the county of Funen (Denmark)

A study of motorcycle fatalities in the period 1977-1983 in the county of Funen, Denmark was compared with an analysis of data obtained from the Accident Register at the Odense University Hospital. Among the operators killed one fifth were illegally operating the motorcycle. A remarkable statistical difference in distribution of accidents involved motorcycles and the total distribution of motorcycles in the county was reported, thus finding an over-representation of heavy motorcycles in the present study. No important differences were found in the distribution of type of accidents compared to other studies. In the present study all but one victim were tested for blood-alcohol concentration (BAC). The results differ from previous studies in as much as 50% of the killed operators of an accident involving motorcycles had a BAC above 0.08%. The reported distribution by age, licensing experience and size of motorcycle in fatal motorcycle accidents seem to support introduction of a graduated licence depending on motorcycle size as well as operator age. Furthermore a limitation in the right to carry a pillion passenger should be considered, and the operator of the motorcycle carrying a pillion passenger should be held responsible for the passenger wearing a helmet.     

Comparison of injuries sustained by drivers and pillion passengers in fatal head-on motorcycle collision accidents

This study aimed to compare injuries sustained by motorcycle drivers with those sustained by pillion passengers in fatal head-on motorcycle collision accidents. We examined 84 cases of fatal head-on motorcycle collision accidents, causing 79 deaths of drivers and 19 deaths of pillion passengers, using medical and medico-legal examination records. The distribution of superficial injuries, characteristic injuries, injury severity as well as fatal causes was evaluated and compared using χ(2) tests. The results revealed a significant difference in the distribution of superficial injuries between drivers and passengers. The proportions of injuries in the hand and perineum regions were significantly higher in drivers than passengers. Some characteristic superficial injuries on the palms, chest, abdomen as well as the perineum areas were observed in drivers, while none of these characteristic injuries were observed in pillion passengers. Drivers were found to have suffered more severe chest and abdomen injuries than passengers. In addition, there was a higher incidence of fatalities involving run-over injuries for drivers compared with pillion passengers. The proportion of fatal injuries related to tumbling was higher for passengers than for drivers. Overall, our results revealed a difference in injury severity, superficial injury distribution and characteristic injuries between drivers and passengers. Few characteristic injuries were found in pillion passengers. These findings could help to guide medico-legal examinations, particularly in identifying drivers among victims involved in traffic accidents.     

贵州省 1 000 例涉嫌酒后驾驶者的鉴定结果分析

目的通过对贵州省2012年1000例涉嫌酒后驾驶、道路交通事故酒精检案的特点进行分析,为预防和控制酒后驾车提供科学数据。方法在利用Excel及Spss统计软件对涉嫌交通事故肇事者性别、年龄、肇事时间、肇事车型以及对肇事者血中乙醇质量浓度（BAC）等数据进行统计分析。结果涉嫌酒后驾驶者男性居多,年龄在20~50岁间占92%。事故多发生于20~24时,以县市区干道为主,肇事车辆为摩托车占46.72%。在1000例乙醇检案中,28.7%为未检出,9.3%为酒后驾车,59.5%为醉酒驾车。结论 2012年贵州省发生的1000例涉嫌酒后驾驶案件中有一定相关特征,可为＂酒驾＂的预防与控制提供准确的科学依据。     

两轮摩托车道路交通事故驾驶员损伤特征分析

目的找出两轮摩托车交通事故中多发于驾驶员而乘员较少发生的损伤特征,为查明案件提供线索。方法统计分析了有驾乘人员死亡的136例及有驾乘人员受伤的32例,以体表擦挫伤、挫裂伤或骨折作为统计对象,分别统计驾乘人员各部位发生损伤数并计算其出现的比例。结果驾驶员出现膝部损伤的比例（34．9％）高于乘员比例（i0．3％）,而驾驶员膝部损伤大多数发生在膝部前侧。结论膝部前侧损伤的当事人应高度怀疑其为真实驾驶员。     

256例儿童和少年道路交通事故伤残评定回顾性研究

目的 探讨儿童和少年道路交通事故活体损伤的流行病学、损伤及伤残评定特点。方法 对256例儿童和少年道路交通事故伤残评定资料进行回顾性研究。结果 男性多于女性,多见于6～18岁儿童,交通事故每天10～12时和16～18时最多,车辆类型以小汽车和货车多见,肇事方式多见于机动车与行人相撞,伤者的交通方式以步行多见,损伤部位以头部和四肢多见,损伤类型以骨折、挫伤、创多见,但内脏损伤相对较轻,下肢骨折远多于上肢。损伤程度多评定为轻伤,伤残程度以Ⅸ、Ⅹ级轻度伤残为主(33.2％)。结论 儿童和少年道路交通事故伤残评定应适当放宽标准,伤残评定标准应增加儿童和少年的有关条款。     

Pathologic features of childhood pedestrian fatalities

A retrospective analysis of 68 cases of fatal childhood pedestrian accidents in South Australia that occurred over a 20-year period from January 1977 to December 1996 was undertaken. The age range was 12 months to 16 years (average, 7.6 years), with a male to female ratio of 41:27. The most common site of significant injury was the head (91.2%), followed by the abdomen (50%), chest (47.1%), and neck (38.2%). The most frequently encountered significant injury combinations involved the head, chest, and abdomen (14.7%); the head and chest (11.8%); and the head, neck, and abdomen (11.8%). Injuries were severe, consisting of extensive compound and comminuted skull fractures, neck fractures, and massive intraparenchymal brain and internal organ damage with avulsions and fragmentation. Non-life-threatening limb injuries occurred in 88% of cases. A distinct subgroup involved infants and younger children playing in driveways at home who were hit by reversing vehicles. The injuries were often of such a severe nature that death was instantaneous and with no possibility of successful medical intervention. More deaths occurred during the winter than summer months.     

Sharp Force Injury Fatalities: A Retrospective Study (1982–2012) in Brescia (Italy)

A retrospective study was carried out on postmortem examination data of 131 sharp force‐related casualties recorded by the Brescia Institute of Forensic Medicine between 1982 and 2012. The objective was to identify relevant parameters that may be used to distinguish the manner of deaths between homicide, suicide, and accident. The following variables were considered: manner of death; demographic data; scene; type of sharp object; location and numbers of wounds; the presence of hesitation marks/defense wounds; toxicological findings; psychiatric history. There were 92 homicides, 28 suicides, and 11 accidents. Most victims were male, with an average age of 43. Injuries in isolation were present in 9.8% of homicides, in 35.7% of suicides, and in 54.5% of accidents. Most injuries involved the left anterior chest in homicides and the forearms in suicides. This study underlines the importance of a meticulous postmortem examination of injuries on the body and their relationship with other results from the death scene investigation.