Infant skull fractures: Accident or abuse?
| Autor: | Xiaogai Li, Håkan Sandler, Svein Kleiven |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Orthodontics
Ossification Head (linguistics) business.industry 010401 analytical chemistry Poison control medicine.disease 01 natural sciences 0104 chemical sciences Pathology and Forensic Medicine Head trauma 03 medical and health sciences Skull 0302 clinical medicine medicine.anatomical_structure Skull fracture Injury prevention medicine 030216 legal & forensic medicine Accidental fall medicine.symptom business Law |
| Zdroj: | Forensic Science International. 294:173-182 |
| ISSN: | 0379-0738 |
| DOI: | 10.1016/j.forsciint.2018.11.008 |
| Popis: | Abusive Head Trauma (AHT) is considered by some authors to be a leading cause of traumatic death in children less than two years of age and skull fractures are commonly seen in cases of suspected AHT. Today, diagnosing whether the observed fractures are caused by abuse or accidental fall is still a challenge within both the medical and the legal communities and the central question is a biomechanical question: can the described history explain the observed fractures? Finite element (FE) analysis has been shown a valuable tool for biomechanical analysis accounting for detailed head geometry, advanced material modelling, and case-specific factors (e.g. head impact location, impact surface properties). Here, we reconstructed two well-documented suspected abuse cases (a 3- and a 4-month-old) using subject-specific FE head models. The models incorporate the anatomical details and age-dependent anisotropic material properties of infant cranial bones that reflect the grainy fibres radiating from ossification centres. The impact locations are determined by combining multimodality images. The results show that the skull fracture patterns in both cases of suspected abuse could be explained by the described accidental fall history, demonstrating the inherent potential of FE analysis for providing biomechanical evidence to aid forensic investigations. Increased knowledge of injury mechanisms in children may have enormous medico-legal implications world-wide. |
| Databáze: | OpenAIRE |
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