对冲性眶壁骨折的法医学鉴定

目的 探讨对冲性眶壁骨折在眼眶骨折中的分类及其发生机制以及法医学鉴定要点。方法 对42例对冲性眶壁骨折的法医学鉴定案例进行回顾性研究,全部资料有明确的致伤原因,均进行临床常规检查及双眼影像学检查。结果 对冲性眶壁骨折在眶壁骨折中占6.2％,致伤同侧42眼均表现为眼球钝挫伤,其中视网膜震荡18眼,重影症15眼,CT扫描显示眶壁无骨折。对侧42眼均无眼球钝挫伤及视网膜震荡表现,其中重影症10眼,CT扫描显示均为眶内壁骨折。双侧84眼全部出现视物模糊及视力下降。结论 致伤同侧眼表现为眼球钝挫伤以及对侧眼CT扫描显示眶内壁骨折为诊断对冲性眶壁骨折的主要指标,损伤程度评定为轻伤。

Forensic investigation of contrecoup orbital wall fracture

Objective To explore the classification of contrecoup orbital wall fractures, the mechanism of their formation and their identification in forensic practice. Method Forty-Two eases of contrecoup orbital wall fraeture were reviewed and studied. Each case has clear history of injury and both eyes have been clinically checked and CT scan performed. Results The contrecoup orbital wall fracture amounts up to 6.2% among eye socket wall fractures. Forty-two cases with home lateral injuries showed eyeball blunt contusion, 18 of them had retina concussion, 15 eyes had diplopia, no fracture on the orbital walls of that side were found by CT scanner. The 42 eyes on the opposite side of the injuries did not show eyeball contusion or retina concussion, but 10 eyes had diplopia and the orbital internal wall fractures were found in all cased by CT scanner. All 84 eyes of these eases had decreased of blurring of vision. Conclusion The main criteria for diagnosing contrecoup orbital wail, fracture is the found of head trauma with home lateral eyeball blant injury and orbital wall fracture at the opposite side proven by CT scanner and also some degree of injury in the eyeball on that side. The damage was assessed to be of minor injury.