Trauma on Human Skeletons: A Study on Cause of Death Related with Trauma

Authors

DOI:

https://doi.org/10.17986/blm.2019149812

Keywords:

Forensic Sciences, Forensic Anthropology, Skeleton, Perimortem, Trauma, Cause of Death

Abstract

Objective:In forensic anthropology, skeletal trauma analysis is conducted to determine the patterns of trauma in violent deaths. Bone fractures, cut marks and other defects observed on the human bones are analyzed in order to determine the manner and the possiblecause of death. The aim of this study was to examine bone fracturing patterns of the victims, utilizing CT scans so as to diagnose the relationship between bone fracture and mortality. It also tested the accuracy and reliability of the perimortem trauma determinations in the forensic anthropological results.

Materials and Methods: The sample of this study consists of 30 cases of forensic significance, and includes 23 male and 7 female individuals who died from traumatic injuries between 20.02.2016 and 29.11.2017. The victims died from traffic accidents, fall from height, hanging and firearm. Gravely injured individuals underwent CT scanning in the national hospital prior to death except for one individual and bone fractures were located by using a 3D medical imaging program.

Results:1580 bones were analyzed and 242 bone fractures were located, independent to the autopsy findings. The results of the study indicated that 28 individuals died from blunt trauma and 2 individuals from gunshot trauma, the number of deaths for men was greater than for females, the highest mortality age range was between 21 and 30 years old and fatal bone fractures were mostly located on the head and chest.

Conclusion:Forensic anthropological analysis results were found to have a success rate of 90% (n=30/27) in determining the trauma type and ...

Downloads

Download data is not yet available.

References

Aktaş EÖ, Kaya A. Yaralama Suçlarının Adli Tıbbi Değerlendirilmesinde Kullanılan Kılavuza Bakış. Adli Tıp Bülteni. 2017;22(1):45-53. https://doi.org/10.17986/blm.2017127141 DOI: https://doi.org/10.17986/blm.2017127141

Gündoğmuş Ü, Balcı Y, Çetin G. Türk Ceza Kanunu’nda Tanımlanan Yaralama Suçlarının Adli Tıp Açısından Değerlendirilmesi, TC Adalet Bakanlığı, Adli Tıp Kurumu, Haziran 2013 güncellenmiş son hali.

Güzel S, Balcı Y, Çetin G. Yeni Türk Ceza Kanunu’nda Tanımlanan Yaralanma Suçlarının Adli Tıp Açısından Değerlendirilmesi ve Adli Rapor Tanzimi İçin Rehber, Eylül 2005.

Karbeyaz K, Gündüz T, Balcı Y. Yeni Türk Ceza Kanunu Çerçevesinde Kemik Kırıklarına Adli Tıbbi Yaklaşım, Ulus Travma Acil Cerrahi Dergisi 2010, 16(5): 453-458.

Berryman EH, Lanfear KA. Forensic Anthropologists in Medical Examiner’s and Coroner’s Offices: A History, A Companion to Forensic Anthropology, ed. By C. D. Dirkmaat, Wiley-Blackwell, 2012, Part VII: 534-548. DOI: https://doi.org/10.1002/9781118255377.ch26

Byers SN. Introduction to Forensic Anthropology: Death, Trauma and the Skeleton, A text book, Pearson and AB, 2010, s. 274-354.

Dirkmaat CD. Developments in Human Skeletal Trauma Analysis, in: A Companion to Forensic Anthropology, Part VII, Ed. By Deniis C. Dirkmaat, Blackwell Publishing, 2012, s.337-339. DOI: https://doi.org/10.1002/9781118255377

Dirkmaat CD. A Companion to Forensic Anthropology, Wiley, Blackwell, 2015, Part VII, p.534-549.

Donato , Luca A, Vecchiotti C, Cipolloni L. Study of Skeletal Remains: Solving a Homicide Case with Forensic Anthropology and Review of the Literature, J.Forensic Anthropol., 2016, 1: 105. https://doi.org/10.4172/jfa.1000105 DOI: https://doi.org/10.35248/2684-1304.16.1.105

Rainwater WC, Crowder C, Hartnett MK, Fridie SJ, Figura JB, Godbold J et al. Forensic Anthropology at the New York Offıce of Chief Medical Examiner, A Companion to Forensic Anthropology, ed. By C.D.Dirkmaat, Wiley-Blackwell, 2012, Part VII: 549-592. DOI: https://doi.org/10.1002/9781118255377.ch27

Pinherio J. Introduction to Forensic Medicine and Pathology, Chapter 2, In: Forensic Anthropology and Medicine: Complementary Sciences From Recovery to Cause of Death, Ed.by S.Schmitt, E.Cunha and J.Pinherio, Humana Press Inc., Totowa, NJ., 2006, p.13-37.

Schmitt A, Cunha E, Pinheiro J. Forensic Anthropology and Medicine; Complementary Sciences from Recovery to Cause of Death, Humana Press, Totowa, New Jersey, 2006.

Stanojevich V. The role of Forensic Anthropologist in a Death Investigation, Univ. Of Ontario Inst. Of Technology, Canada, June 18, 2012. https://doi.org/10.4172/2157-7145.1000154 DOI: https://doi.org/10.4172/2157-7145.1000154

Burke P.M. Forensic Pathology of Fractures and Mechanisms of Injury, Postmortem CT Scanning, CRC Press LLC, 2012. DOI: https://doi.org/10.1201/b11494

Campobasso CP, Dell’Erba AS, Belviso M., MD, Di Vella G. Craniofacial Identification by Comparison of Antemortem and Postmortem Radiographs Two Case Reports Dealing With Burnt Bodies, Am J Forensic Med Pathol, 2007, 28: 182–186. https://doi.org/10.1097/PAF.0b013e31806195cb DOI: https://doi.org/10.1097/PAF.0b013e31806195cb

Harris L.S. Postmortem Magnetic Resonance Images Of The Injured Brain: Effective Evidence In The Courtroom, Foren. Sci. Int. 50 (1991) 179–185. DOI: https://doi.org/10.1016/0379-0738(91)90149-D

HartBL, Dudley MH, Zumwalt RE. Postmortem Cranial MRI and Autopsy Correlation in Suspected Child Abuse, Am. J Forensic Med Pathol. 1996 Sep, 17 (3): 217-24. DOI: https://doi.org/10.1097/00000433-199609000-00008

Lathrop LS, Nolte BK. Utility of Postmortem X-ray Computed Tomography (CT) in Supplanting or Supplementing Medicolegal Autopsies, Final Technical Report NIJ Award 2010-DN-BX-K205, accepted January 2016, s.1-97.

Nolte KB, Mlady G, Zumwalt RE, Cushnyr B, Paul ID, Wiest PW. Postmortem X-ray Computed Tomography (CT) and Forensic Autopsy: A Review of the Utility, the Challenges and the Future Implications, Academic Forensic Pathology, 2011, 1(1):40-51. https://doi.org/10.23907/2011.007 DOI: https://doi.org/10.23907/2011.007

Ateşçelik M, Gürger M. Acil Servise Künt Travma ile Başvuran Hastaların İncelenmesi, 2013, Cilt 18, Sayı 2, 2013, Sayfa(lar) 103-108.

El-Menyar A, El-Hennawy H, Al-Thani H, Asim M, Abdelrahman H, Zarour A et al. Traumatic injury among females: does gender matter?, J Trauma Manag. Outcomes. 2014, 8: 8. https://doi.org/10.1186/1752-2897-8-8 DOI: https://doi.org/10.1186/1752-2897-8-8

Gören S, Subaşı M, Tıraşcı Y, Kaza Z. Trafik Kazalarına Bağlı Ölümler, Türkiye Klinikleri Adli Tıp Dergisi, 2005, 2:9-13.

Leth PM, Ibsen M. Abbreviated Injury Scale Scoring in Traffic Fatalities: Comparison of Computerized Tomography and Autopsy, Journal of Trauma Injury, Infection, and Critical Care, June 2010, 68(6):1413-6. https://doi.org/10.1097/TA.0b013e3181b251b8. DOI: https://doi.org/10.1097/TA.0b013e3181b251b8

Topcuoğlu MŞ, Kısacıkoğlu B, Salih K, Pekediz A, Yalınız H, Bayram H et al. Alt Ekstremitenin İskelet ve Yumuşak Dokular ile Komplike Vasküler Yaralanmalarda Properatif Değerlendirme, UTD 1996, 2:180-4.

Yağmur Y, Uğur M, Kara İH, Güloğlu C, Aldemir M, Kiraz M. Acil Servise Başvuran Multitravmalı Olgularda Travma Skorları ile AT-III, Trombosit Sayısı, APTT, PT ve Fbrinojen Düzeylerinin Değerlendirilmesi, T. Klin. J. Med. Sci., 2000, 20:123-31.

Veysi VT, Vassilios SN, Paliobeis C, Efstathopoulos N. Prevalence of chest trauma, associated injuries and mortality: a level I trauma centre experience, Int. Orthop., 2009 Oct, 33(5): 1425–1433. https://doi.org/10.1007/s00264-009-0746-9. DOI: https://doi.org/10.1007/s00264-009-0746-9

Değirmenci B, Akar T, Demirel B. Ölümlü Trafik Kazalarının Adli Tıp Açısından Değerlendirilmesi, Gazi Medical Journal, 2015, Vol 26. No.4 DOI: https://doi.org/10.12996/gmj.2015.44

Demirel, BC. Kafa ve Yüz Travmalarının Adli Tıp Açısından Önemi, T.C. Ege Üniversitesi Tıp Fakültesi Adli Tıp Ana Bilim Dalı, Bitirme Tezi, 2015, İzmir.

Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib Fractures in The Elderly, J Trauma-Injury Infec Crit Care. 2000, 48(6):1040–1046. DOI: https://doi.org/10.1097/00005373-200006000-00007

Lee RB, Bass SM, Morris JA, Jr MacKenzie EJ. Three or more rib fractures as an indicator for transfer to a Level I trauma center: a population-based study, J. Trauma-Injury Infect Crit Care.,1990, 30(6):689–694. DOI: https://doi.org/10.1097/00005373-199006000-00006

Sirmali M, Türüt H, Topçu S, Gülhan E, Yazici U, Kaya S et al. A Comprehensive Analysis of Traumatic Rib Fractures: Morbidity, mortality and management, European Journal of Cardio-Thoracic Surgery, 1 July 2003, 24 (1): 133–138. DOI: https://doi.org/10.1016/S1010-7940(03)00256-2

Lau E, Ong K, Kurtz S, Schmier J, Edidin A. Mortality Following the Diagnosis of a Vertebral Compression Fracture in the Medicare Population, J Bone Joint Surg Am. 2008 Jul;90(7):1479-86. https://doi.org/10.2106/JBJS.G.00675. DOI: https://doi.org/10.2106/JBJS.G.00675

Makino Y, Yokota H, Nakatani E, Yajima D, Inokuchi G, Motomura A et al. Differences between postmortem CT and autopsy in death investigation of cervical spine injuries, Forensic Sci Int., 2017 Dec, 281:44-51. https://doi.org/10.1016/j.forsciint.2017.10.029. DOI: https://doi.org/10.1016/j.forsciint.2017.10.029

Godoy JMP, Echeverria FR, Baitello LA, Espada PC, Morioka YR. Prevalence of Death Due to Pulmonary Embolism After Trauma, Lung India. 2010 Apr-Jun, 27(2): 72–74. https://doi.org/10.4103/0970-2113.63610 DOI: https://doi.org/10.4103/0970-2113.63610

Alunni-Perret V, Muller-Bolla M, Laugier JP, Lupi-Pegurier L, Bertrand MF, Staccini P et al. Scanning Electron Microscopy Analysis of Experimental Bone Hacking Trauma, J. Forensic Sci., 2005, 50(4): 796–801. DOI: https://doi.org/10.1520/JFS2003213

Ambade VN, Godbole HV. Comparison of Wound Patterns in Homicide by Sharp and Blunt Force, Forensic Sci. Int.,2006, 156: 166-170. https://doi.org/10.1016/j.forsciint.2004.12.027 DOI: https://doi.org/10.1016/j.forsciint.2004.12.027

Bashir M, McWilliams RG, Desmond M, Kuduvalli M, Oo A, Field M. Blunt Aortic Injury Secondary to Fragmented Tenth Thoracic Vertebral Body, Ann. Thorac. Surg, 2013, (95): 2161-2164. https://doi.org/10.1016/j.athoracsur.2012.09.065. DOI: https://doi.org/10.1016/j.athoracsur.2012.09.065

Berryman HE, Symes SA. Recognizing Gunshot and Blunt Cranial Trauma Through Fracture Interpretation, Forensic Osteology, Ed. By K.J.Reichs (1998), s. 333-352.

Fachhini F, Rastelli E, Belcastro MG. Peri Mortem Cranial Injuries from a Medieval Grave in Saint Peter’s Cathedral, Bologna, Italy, Int. J. Osteoarchaeol., 2008, 18: 421–430. https://doi.org/10.1002/oa.949 DOI: https://doi.org/10.1002/oa.949

Gina O, Hart MA. Fracture Pattern Interpretation in the Skull: Differentiating Blunt Force From Ballistics Trauma Using Concentric Fractures, Journal of Forensic Sciences, Volume:50, Issue:6, November 2005, s. 1276-1281. DOI: https://doi.org/10.1520/JFS2004219

Gozna ER. Biomechanics of Long Bone Injuries, In E.R. Gozna and I.J. Harrington (eds), Biomechanics of Musculoskeletal Injury Williams and Wilkins, Baltimore, MD., 1982, s. 1-24.

Harkess JW, Ramsey WC, Harkess JW. Principles of fractures and dislocations, In C.A. Rockwood, D.P., 1996.

Humphrey C, Kumaratilake J, Henneberg M. Variability of Characteristics of Cranial Projectile Trauma in Skeletal Material, Anthropol Anz., 2017 Dec 1,74(4):283-296. https://doi.org/10.1127/anthranz/2017/0774. DOI: https://doi.org/10.1127/anthranz/2017/0774

Gurdjian ES, Webster JE, Lissner HR. The Mechanism of Skull Fracture, Radiology, 1950, 54(3): 313 – 338. https://doi.org/10.1148/54.3.313 DOI: https://doi.org/10.1148/54.3.313

Kimmerle EH, Baraybar JP, Skeletal Trauma: Identification of Injuries Resulting From Human Rights Abuse and Armed Conflict, CRC Press Taylor & Francis Group, USA 2008. DOI: https://doi.org/10.1201/9781420009118

Lovell Nancy C. Trauma Analysis in Paleopathology, Yearbook Of Physical Anthropology, 1997, 40:139-170. DOI: https://doi.org/10.1002/(SICI)1096-8644(1997)25+<139::AID-AJPA6>3.0.CO;2-#

McNulty LS. An Analysis of Skeletal Trauma Patterning of Accidental and Intentional Injury, PhD diss, The University of Tennessee, Knoxville, 2016.

Passalacqua VN, Rainwater WC. Skeletal Trauma Analysis: Case Studies in Context, Wiley Blackwell, 2015. DOI: https://doi.org/10.1002/9781118384213

Pechnikova M. Forensic Analysis of Bone Fractures Caused by Blunt Force Trauma, PhD diss., Masaryk University, Czech Republic, 2013.

Cecchetto G, Fais P, Giraudo C, Boscolo-Berto R, Amagliani A, Miotto D et al. Micro-CT Features of Intermediate Gunshot Wounds Severely Damaged by Fire, Int. J. Legal Medicine, March 2013, Volume 127, Issue 2, pp 419–425. https://doi.org/10.1007/s00414-012-0775-6. DOI: https://doi.org/10.1007/s00414-012-0775-6

Downloads

Published

2019-03-28

Issue

Section

Research Article

How to Cite

1.
Çeker D, Deniz İdris, Sevim A. Trauma on Human Skeletons: A Study on Cause of Death Related with Trauma. Bull Leg Med [Internet]. 2019 Mar. 28 [cited 2025 Sep. 6];24(1):17-29. Available from: https://www.adlitipbulteni.com/index.php/atb/article/view/1248