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61.
目的探讨胸腰椎压缩性骨折压缩程度不同评估方法间的差异。方法 1.选取211例胸腰椎压缩性骨折X线片资料,用4种方法以压缩椎体前缘高度分别与其后缘、上一椎体前缘、下一椎体前缘、上下椎体前缘高度均值比较,评估相应压缩程度并比较各方法间的差异。2.选取其中146例,测量压缩椎体相邻上方三个正常椎体高度,比较中位椎体前缘高度分别与其后缘、上一椎体前缘、下一椎体前缘、上下椎体前缘高度均值的差异。结果 1.压缩椎体前缘分别与后缘、上一椎体前缘、上下椎体前缘高度均值评估的压缩程度,两两组间P0.05;但压缩椎体前缘与后缘、下一椎体前缘评估组间P0.05。2.正常中位椎体前缘与后缘、上一椎体前缘、下一椎体前缘高度组间均P0.05,而与上下椎体前缘高度均值组间P0.05,且一致性较好。结论本文不同方法对胸腰椎骨折压缩程度评估存在差异,压缩椎体前缘与上下椎体前缘高度均值比较评估其压缩程度更准确。  相似文献   
62.
法医鉴定工作中,需要明确判断鼻骨骨折为新鲜形成,方可作为人体损伤鉴定的依据.通过案例追踪复查与已知陈旧鼻骨骨折对照及临床表现等方法,依据骨折断端锐利、骨折部位粘膜肿胀、软组织内有小片状低密度影等CT影像表现,结合伤后鼻面部肿胀、鼻出血、鼻腔通气不畅等临床表现作为新鲜鼻骨骨折的影像诊断指标.工作中,须重视鼻骨骨折新旧伤的...  相似文献   
63.
利用颅骨枪弹创骨折类型推断射击方向和顺序的实验   总被引:1,自引:0,他引:1  
建立利用颅骨枪弹创骨折类型推断射击方向和顺序的方法。使用国产五四式7.62mm口径手枪及五六式7.62mm口径半自动步枪,以3m的距离2次射击16具尸体的头颞部及枕部,造成颅脑贯通创,制成颅骨枪弹射入、出口各32例,并根据定位标记进行观察。结果显示:颅骨枪弹创骨折形态可分为带有斜面的孔状骨折,锁孔状骨折,放射状骨折和环状隆起骨折4种类型,其出现多见于低速枪射击,并与射击方向和顺序有直接关系。根据颅骨枪弹创骨折类型可推断射击方向和顺序。  相似文献   
64.
    
Four cases of in‐custody or unlawful death are presented as examples of increased bone fragility with an associated increase in fracture rates due to ethanol‐induced osteopenia. In addition, one of the individuals suffered fractures several weeks premortem, allowing some healing to take place. Using radiographs and physical examination, the ribs from these individuals are compared with those retained from three individuals with no history of alcoholism to illustrate diagnostic characteristics that will be notable using standard autopsy and anthropological procedures. Trabecular bone mass is notably decreased in the alcoholic group leading to a greater chance of fracture occurring during conflict, including arrest and in‐custody situations. The average number of perimortem fractures among the alcoholic individuals is 15, while the control group is six. In the case of the individual with healing, the degree of bone repair on the ribs was less than is expected considering the interval between injury and death.  相似文献   
65.
    
This study highlights complexities associated with postsurgical trauma interpretation of a 76‐year‐old female patient from a psychiatric institution in Mexico. The skeletal analysis identified complications from an unsuccessful surgical operation for an intertrochanteric fracture of the femur. An improperly placed surgical plate resulted in nonunion due to limited contact between fracture margins. However, it is unclear whether this resulted from surgical complications, ineffective postoperative care, or from the decedent's limited ability to follow postoperative care instructions. Additionally, failure of the plate resulted in degenerative changes to the acetabulum. These complications, associated with degenerative changes to upper limb joints, suggest significant mobility issues. The pattern of antemortem trauma and contextual information support a conclusion of postoperative medical neglect, a documented problem in psychiatric institutions in Latin America. This study provides insight into the relevance of detailed trauma assessment of skeletal remains in cases where neglect and human rights violations are suspected.  相似文献   
66.
    
Skull fracture characteristics are associated with loading conditions (such as the impact point and impact velocity) and could provide indication of abuse or accident‐induced head injuries. However, correlations between fracture characteristics and loading conditions in infant and toddler are ill‐understood. A simplified computational model representing an infant head was built to simulate skull responses to blunt impacts. The fractures were decided through a first principal strain‐based element elimination strategy. Simulation results were qualitatively compared with test data from porcine heads. This simplified model well captured the fracture pattern, initial fracture position, and direction of fracture propagation. The model also very well described fracture characteristics found in studies with human infant cadaveric specimens. A series of parametric studies was conducted, and results indicated that the parameters studied had substantial effects on fracture patterns. Additionally, the jagged shapes of sutures were associated with strain concentrations in the skull.  相似文献   
67.
    
It is important to conduct timing of injury research analyzing fracture characteristics at known postmortem intervals (PMI) because bone can retain fresh characteristics throughout the PMI. Defleshed pig (Sus scrofa) long bones were fractured weekly in two environments (full sun and shade) over 14 weeks in Central Florida and fracture characteristics were categorized (N = 136) for analysis. Results of analysis of variance (ANOVA) using time in weeks (PMI) as a dependent variable indicate significant relationships between PMI and Fracture Angle (p < 0.001), Fracture Surface (p < 0.001), and Fracture Outline (p < 0.001). Fracture characteristics associated with perimortem trauma (smooth Fracture Surfaces and curved or V‐shaped Fracture Outlines) were commonly observed. Analysis of fracture characteristics for each environment demonstrated similar patterns. Overall, the loss of only fresh fracture characteristics for each bone was noted earlier in the PMI for the Central Florida region than previously reported.  相似文献   
68.
    
Following the death of a woman with blunt force chest trauma, the question was asked how common was the finding at autopsy of a flail chest in decedents after failed cardiopulmonary resuscitation. It was suggested in court that this was an uncommon occurrence. To address this issue, autopsy cases in adults (>18 years) with rib fractures attributable to cardiopulmonary resuscitation were taken from the files of Forensic Science SA over a 7‐year period from 2008 to 2014. Flail chest injuries were defined as those arising from fractures at two sites in at least three consecutive ribs. From 236 cases with rib fractures attributed to resuscitation, a total of 43 flail chest injuries were found in 35 cases (14.8%). The majority occurred in the 60‐79‐year‐old age group. These data suggest that flail chest injuries are a more common sequelae of cardiopulmonary resuscitation than has been previously appreciated in autopsy cases, particularly in the elderly.  相似文献   
69.
    
Better understanding of the timing of fracture healing may help in cases of interpersonal violence but also of personal identification. The intra- and inter-rater agreement for the adapted fracture healing scale (AFHS) assessing the post-traumatic time interval on radiographs were tested. This is a preliminary study, providing essential information on method reliability for upcoming studies using the AFHS. Five raters (two radiologists, a forensic pathologist, an orthopedist, and an anthropologist) were presented with a test in three parts consisting of 85 radiographs (from 30 adults) of fractures of tubular bones in different stages of healing purposefully selected from more than 1500 radiographs. The raters were firstly asked to assess 15 features describing fracture healing as present, absent, or not assessable. Thereafter, the raters were asked to choose from the AFHS a single-stage best representing the observed healing pattern. The intra- and inter-rater agreement were assessed using single-rating, absolute agreement, two-way mixed-effects intra-class correlation (ICC) coefficients. The intra-rater ICC of radiologist 1 ranged from 0.80 to 0.94. The radiologists’ inter-rater ICC ranged from 0.68 to 0.74, while it ranged from −0.01 to 0.90 for the other raters. The good to excellent ICC among the radiologists and forensic anthropologist provides good foundation for the use of the AFHS in forensic cases of trauma dating. The poor to good results for the other physicians indicate that using the AFHS requires training in skeletal anatomy and radiology.  相似文献   
70.
    
Current literature associates bending failure with butterfly fracture, in which fracture initiates transversely at the tensile surface of a bent bone and branches as it propagates toward the impact surface. The orientation of the resulting wedge fragment is often considered diagnostic of impact direction. However, experimental studies indicate bending does not always produce complete butterfly fractures or produces wedge fragments variably in tension or compression, precluding their use in interpreting directionality. This study reports results of experimental 3‐point bending tests on thirteen unembalmed human femora. Complete fracture patterns varied following bending failure, but incomplete fractures and fracture surface characteristics were observed in all impacted specimens. A flat, billowy fracture surface was observed in tension, while jagged, angular peaks were observed in compression. Impact direction was accurately reconstructed using incomplete tension wedge butterfly fractures and tension and compression fracture surface criteria in all thirteen specimens.  相似文献   
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