掌骨骨折致伤方式法医学鉴定附27例分析

目的探讨掌骨骨折的形成机制，为掌骨骨折致伤方式的法医学推断提供参考。方法通过对27例致伤方式明确的掌骨骨折案例进行回顾性分析．对不同部位、性质的掌骨骨折结合其致伤方式进行损伤机制分析，并分类统计。结果诸掌骨中以第5掌骨骨折最为常见。就部位而言，又以基底部骨折最为常见，多见于间接暴力传导作用所致；其次为掌骨颈骨折．往往为纵向暴力作用所致。常见于攻击伤、撞击伤；掌骨头骨折常见于握拳时暴力直接打击所致；掌骨体横行或粉碎性骨折为直接暴力作用所致．斜形或螺旋形骨折多为旋转暴力作用所致。结论根据掌骨骨折的部位、性质，通过分析其骨折的形成机制，可以推断其致伤方式，从而为司法鉴定提供有力证据。

Forensic Medical Examination of Injury Manners of Metacarpal Fracture with Analysis of 27 Cases

Objective To explore the formation mechanism of metacarpal fractures in different parts, and to provide reference for injury manner identification of metacarpal fractures. Method 27 patients with clear manner of metacarpal fracture injury were analyzed retrospectively, and data are classified statistically. Results The fifth metacarpal fracture is the most common fracture in all metacarpal bones. The base of metacarpal bone is the most frequent part to fracture, which is generally caused by indirect violence. Followed is the metacarpal neck fracture, which is generally caused by direct violence in attacks and traumas. Metacarpal head fracture is usual in a fist fight under the direct result of violence. Transverse or comminuted metacarpal body fracture is caused by direct physical violence. Oblique or spiral fracture is mostly caused by rotary violence. Conclusion According to the metacarpal fracture location and nature, by analyzing the formation mechanism of fracture, the injury manner could be inferred and used as evidence in forensic medical examination.