Bilateral fractures of transverse processus: A diagnostic sign of overrun?
Summary of "Bilateral fractures of transverse processus: A diagnostic sign of overrun?"
Injuries caused by traffic accidents can be complex and extensive. Due to the highly dynamic course of actions, reconstructive questions may be challenging to investigators. Differentiation of a single collision from an overrun is a central question. We hypothesized that the existence of spine fractures such as spinous and transverse processus fractures may be helpful to distinguish both. The postmortem CT-data of pedestrian fatalities were analyzed in a retrospective manner. A group finally assessed as being overrun (n=13; 7m, 6 f, 18-86y, mean 65y) and a control group being hit but not overrun (n=11; 7m, 4 f, 31-89y, mean 61y) were compared. Secondarily, the CT results were compared to the localization of fractures detected in routine autopsy. Cases in the overrun group showed 1-31 fractures of processus (mean 14.6) and 9 cases presented with bilateral fractures of partly opposite transverse processus. In the control group there were 6 cases without any fractures and 5 cases showed 1-9 injuries (mean 1.7). There were no bilateral fractures of transverse processus in the control group. Autopsy only detected fractures of spinous processus in 4 cases from the overrun group. Bilateral fractures of transverse processus are a possible sign for an overrun. Unilateral fractures of the transverse processus are not specific. Post-mortem CT is more sensitive for the evaluation of vertebral processus than conventional autopsy.
Affiliation
Institute of Legal Medicine, University of Zürich, Winterthurerstrasse 190/52, CH-8057 Zürich, Switzerland.
Journal Details
This article was published in the following journal.
Name: Forensic science international
ISSN: 1872-6283
Pages: 244-7
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22342540
- DOI: http://dx.doi.org/10.1016/j.forsciint.2012.01.013
Medical and Biotech [MESH] Definitions
Osteotomy, Le Fort
Transverse sectioning and repositioning of the maxilla. There are three types: Le Fort I osteotomy for maxillary advancement or the treatment of maxillary fractures; Le Fort II osteotomy for the treatment of maxillary fractures; Le Fort III osteotomy for the treatment of maxillary fractures with fracture of one or more facial bones. Le Fort III is often used also to correct craniofacial dysostosis and related facial abnormalities. (From Dorland, 28th ed, p1203 & p662)
Femoral Neck Fractures
Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are HIP FRACTURES.
Hip Fractures
Fractures of the FEMUR HEAD; the FEMUR NECK; (FEMORAL NECK FRACTURES); the trochanters; or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region (FEMORAL FRACTURES).
Skull Fractures
Fractures of the skull which may result from penetrating or nonpenetrating head injuries or rarely BONE DISEASES (see also FRACTURES, SPONTANEOUS). Skull fractures may be classified by location (e.g., SKULL FRACTURE, BASILAR), radiographic appearance (e.g., linear), or based upon cranial integrity (e.g., SKULL FRACTURE, DEPRESSED).
Transverse Sinuses
The two large endothelium-lined venous channels that begin at the internal occipital protuberance at the back and lower part of the CRANIUM and travels laterally and forward ending in the internal jugular vein (JUGULAR VEINS). One of the transverse sinuses, usually the right one, is the continuation of the SUPERIOR SAGITTAL SINUS. The other transverse sinus is the continuation of the straight sinus.
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