Features of complex forensic medical examinations (FME) of the lower extremities mechanical injury in non-fatal car trauma

Authors

DOI:

https://doi.org/10.26641/1997-9665.2020.3.76-84

Keywords:

car trauma, pedestrians, the lower extremities injury, forensic medical examination

Abstract

Background. Establishing of a mechanism of car trauma requires a number of FMEs in connection with a formation of various body segments injuries in different phases on different surfaces with different mechanisms of traumatic effects. The  objective of this research is to study reasons for the appointment and the content of complex FMEs in case of car trauma with mechanical injury of the lower extremities. Methods. Material - 70 acts of complex FMEs, carried out on the fact of a non-fatal car trauma wit the lower extremities injury for the period February - June 2018. Methods - retrospective analysis, descriptive statistics. Results. Victims were mostly male (77.1%) pedestrians (97.1%). Main reasons for the appointment of complex FMEs are the establishment of a causal relationship between: a) the mechanism of injury, mechanical damage of a car and an outcome of the injury (48.6%) and b) the mechanism and the outcome of the injury (32.9%). At preliminary stage, 83 FMSs were carried out; more often than others were appointed: vehicle inspection (14.3%), automotive (14.3%), commission (12.9%), forensic (61.4%) expertises. Within the framework of complex FMEs, autotechnical (51.4%), transport and traceological (24.3%) expertises, vehicle inspection (38.6%) were carried out; total of 88 expertises. The main blocks of questions of complex SMEs: the mechanism and sequence of bodily injury formation; the position of a pedestrian at the time of initial contact with a vehicle; the nature and sequence of car mechanical damages; an ability to prevent road traffic accident by a driver. Conclusion. One of ways to optimize FMEs of car trauma is to standardize protocols for trauma patients examination, including with detailed display of specific stamp injuries of the integumentary system

References

  1. The UN Road Safety Collaboration: Global plan for the decade of action for road safety 2011-2020. Available at: http://www.who.int/roadsafety/ decade_of_action/plan/plan_english.pdf [accessed 21.06.15].
  2. Global status report on road safety 2018. Geneva: World Health Organization; 2018. Licence: CC BY- NC-SA 3.0 IGO. 403 р.
  3. Gokalp MA, Hekimoglu Y, Gozen A, Guner S, Asirdizer M. Evaluation of severity score in patients with lower limb and pelvic fractures injured in motor vehicle front-impact collisions Med Sci Monit, 2016;22:4692-98. doi: 10.12659/MSM.898459 PMID: 27905350
  4. Aleassa EM, Eid HO, Abu-Zidan FM. Effects of vehicle size on pedestrian injury pattern and severity: prospective study. World J Surg. 2013;37(1):136-40. doi: 10.1007/s00268-012-1797-4 PMID: 23015221
  5. [Law of Ukraine "On Forensic Examination" in accordance with the Resolution of the Verkhovna Rada of Ukraine of February 25, 1994 N 4038a-XII]. Ukrainian
  6. [«Instruction on forensic medical examination" approved by the order of the Ministry of Health of Ukraine of January 17, 1995 N 6]. Ukrainian.
  7. Department for Transport Scottish Government Welsh Assembly Government. Reported road casualties Great Britain 2012. London, Department for Transport Great Minster House, 2013.
  8. Bouaoun L, Haddak MM, Amoros E. Road crash fatality rates in France: A comparison of road user types, taking account of travel practices. Accid Anal Prev, 2015;75:217–25. DOI: 10.1016/j.aap.2014.10.025
  9. Ammori MB, Eid HO, Abu-Zidan FM. Lower limb and associated injuries in frontal-impact road traffic collisions. Afr Health Sci. 2016;16(1):306-10. http://dx.doi.org/10.4314/ahs.v16i1.40 PMID: 27358646
  10. Decker S, Otte D, Cruz DL, Muller CW, Omar M, Krettek C, et al. Injury severity of pedestrians, bicyclists and motorcyclists resulting from crashes with reversing cars. Acc Anal Prev. 2016;94:46–51. https://doi.org/10.1016/j.aap.2016.05.010
  11. Watanabe R, Katsuhara T, Miyazaki H, Kitagawa Y, Yasuki T. Research of the relationship of pedes- trian injury to collision speed, car-type, impact location and pedestrian sizes using human FE model (THUMS Version 4). Stapp Car Crash J. 2012;56:269-321. PMID: 23625564
  12. Roudsari BS, Mock CN, Kaufman R. An evaluation of the association between vehicle type and the source and severity of pedestrian injuries. Traffic Inj Prev. 2005;6(2):185-92. doi: 10.1080/15389580590931680. PMID: 16019404.
  13. Semenov AV, Sorokovikov VA. [The scales for estimation on injury severity and prediction of outcomes of injuries]. Polytrauma. 2016;2:80-90. Russian.
  14. Reith G, Lefering R, Wafaisade A, Hensel KO, Paffrath T, Bouillon B, Probst C. Injury pattern, outcome and characteristics of severely injured pedestrian. Scand J Trauma Resusc Emerg Med. 2015;23:56. DOI 10.1186/s13049-015-0137-8 PMID: 26242394
  15. Shi L, Han Y, Huang H, Li Q, Wang B, Mizuno K. Analysis of pedestrian-to-ground impact injury risk in vehicle-to-pedestrian collisions based on rotation angles. J Safety Res. 2018;64:37-47. https://doi.org/10.1016/j.jsr.2017.12.004
  16. Fracture and Dislocation Compendium—2018. A joint collaboration between the Orthopaedic Trauma Association and the AO Foundation. J Orthop Trauma. 2018; 32(1):Suppl. DOI: 10.1097/BOT.0000000000001063
  17. Yu W, Chen H, Lv Y, Deng Q, Kang P, Zhang L. Comparison of influencing factors on outcomes of single and multiple road traffic injuries: A regional study in Shanghai, China (2011- 2014). PLoS ONE. 2017;12(5):e0176907. https://doi.org/ 10.1371/journal.pone.0176907 PMID: 28493893
  18. Watanabe R, Katsuhara T, Miyazaki H, Kitagawa Y, Yasuki T. Research of the relationship of pedestrian injury to collision speed, car-type, impact location and pedestrian sizes using human FE model (THUMS version 4). Stapp Car Crash J. 2012;56:269–321. DOI: 10.1371/journal.pone.0176907 PMID: 23625564
  19. Li G, Yang J, Simms C. Safer passenger car front shapes for pedestrians: A computational approach to reduce overall pedestrian injury risk in realistic impact scenarios. Acc Anal Prev. 2017;100:97–110. https://doi.org/10.1016/j.aap.2017.01.006
  20. Scattina A, Mo F, Masson C, Avalle M, Arnoux Pierre J. Analysis of the influence of passenger vehicles front-end design on pedestrian lower extremity injuries by means of the LLMS model. Traf Inj Prev. 2018;19:5:535-541. DOI: 10.1080/15389588.2018.1432858 PMID: 29381438
  21. Verzosa N, Miles R. Severity of road crashes involving pedestrians in Metro Manila, Philippines. Accid. Anal. Prev. 2016; 94:216–26. https://doi.org/10.1016/j.aap.2016.06.006
  22. Elliott JR, Simms CK, Wood DP. Pedestrian head translation, rotation and impact velocity: The influence of vehicle speed, pedestrian speed and pedestrian gait. Accid. Anal. Prev. 2012;45:342–53. https://doi.org/10.1016/j.aap.2016.06.006
  23. Tang J, Zhou Q, Nie B, Yasuki T, Kitagawa Y. Influence of Pre-impact Pedestrian Posture on Lower Extremity Kinematics in Vehicle Collisions. SAE Int J Transp Saf. 2016;4(2):278-88. DOI: 10.4271/2016-01-1507
  24. Li G, Yang J, Simms C. The influence of gait stance on pedestrian lower limb injury risk. Accident; analysis and prevention. Accid. Anal. Prev. 2015;85:83–92. DOI: 10.1016/j.aap.2015.07.012
  25. Liu W, Su S, Qiu J, Zhang Y, Yin Z. Exploration of Pedestrian Head Injuries—Collision Parameter Relationships through a Combination of Retrospective Analysis and Finite Element Method. Int J Environ Res Public Health. 2016;13:1250. doi:10.3390/ijerph13121250. PMID: 27999278
  26. D’elia A, Newstead S. Pedestrian Injury Outcome as a Function of Vehicle Market Group in Victoria, Australia. Traffic Inj Prev. 2015;16(7):709-14. https://doi.org/10.1080/15389588.2014.1003819

Downloads

How to Cite

Sokol, V. K. (2020). Features of complex forensic medical examinations (FME) of the lower extremities mechanical injury in non-fatal car trauma. Морфологія / Morphologia / Morfologìâ, 14(3), 76–84. https://doi.org/10.26641/1997-9665.2020.3.76-84

Issue

Vol. 14 No. 3 (2020)

Section

Статті

License

Copyright (c) 2020 Morphologia

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

 The authors reserve the right to authorship of their work and transfer to the Journal the right to the first publication of this work under the terms of a license Creative commons Attribution 4.0 International (CC BY 4.0), which allows other people to freely distribute the published work with a mandatory reference to the authors of the original work and the first publication of the work in this journal.
        By submitting a manuscript to the editorial office of the Journal ‘Morphologia’ authors agree to transfer the rights to protect and use the manuscript (all supplemental materials, particularly protected objects such as photos, drawings, diagrams, tables, etc.), including the reproduction in the press and distribution via the Internet; translation of the manuscript into any language; export and import of journal copies with the Authors’ article in order to make it available for public. Authors convey the rights mentioned above to the editorial office without any temporal or territorial limitation all over the world. 
        The Authors guarantee that they have the exclusive rights to use the material transferred to editorial office. Editors are not responsible to third parties for contraventions of warranty given by the Authors. The considered rights are transferred to the editorial office since the moment when the current issue is signed for publishing. Reproduction of materials published in the Journal by other individuals and legal entities is possible only with the consent of Editorial office, with the obligatory indication of the full bibliographic reference of the primary publication. The Authors reserve the right to use the published material, its fragments and parts for teaching materials, oral presentations, dissertation thesis prepararion with obligatory bibliographic citation of the original paper. Electron copy of the published article, downloaded from official journal web-site in .pdf format may be put by authors on the official web-site of their institutions, any other official resources with open access.