创伤性骨关节炎法医学鉴定41例分析

目的探讨创伤性骨关节炎的法医学鉴定要点。方法总结苏州同济司法鉴定所2006~2010年受理的41例创伤性骨关节炎法医临床学鉴定案例,对被鉴定人的性别、年龄、致伤方式、损伤部位、损伤形态、影像学表现、治疗方式、创伤性骨关节炎确诊的时间间隔等资料进行回顾性统计、分析。结果法医学检验检见生理结构破坏合并功能障碍7例,功能障碍30例,生理结构与功能检查均未见明显异常9例,另2例临床于外伤后短时间内即诊断为创伤性骨关节炎的,法医学鉴定时未予认定。创伤性骨关节炎影像学表现的严重程度与疼痛、功能障碍等临床表现并没有显著的相关性。结论创伤性骨关节炎作为骨折后常见的并发症之一,好发于负重关节,发生的间隔时间不一,其临床表现严重程度较影像学表现对法医学鉴定意见的意义更大。

Analysis of 41 Forensic Medical Cases of Traumatic Osteoarthritis

Objective To explore the key points in forensic medical examination of traumatic osteoarthritis.Method 41 recent forensic medical cases of traumatic osteoarthritis were reviewed.Data including the object＇s gender,age,type and site of injury,injury pattern,imaging findings,treatment,and time interval before traumatic osteoarthritis confirmed were analyzed retrospectively.Results It was found that there were combined damage and dysfunction of physiological structure in 7 cases,dysfunction in 30 cases,and no obvious abnormality in 9 cases.The other 2 cases were diagnosed as traumatic osteoarthritis in a short period of time after injury,but not confirmed in forensic medical examination.The severity of traumatic osteoarthritis in imaging findings was not significantly related to clinical manifestations（such as pain,dysfunction）.Conclusion As one of the common complications after fracture,traumatic osteoarthritis frequently occurs in weight-bearing joints,and the time interval before occurrence varies.Its severity in clinical manifestations has more significant effect on forensic medical examination than that in imaging findings.