Sokol V. K.

FORENSIC MEDICINE

Scentific article

Interpretation of injuries during forensic medical examinations can be based on medical records, and therefore requires careful assessment and documentation of all injuries sustained by a victim. Purpose – to study the frequency and nature of issues requiring resolution during the primary forensic medical examination of victims with mechanical injuries of the lower extremities as a result of a car injury. Object and methods. The research material – 170 reports of primary forensic medical examinations of victims in with fractures of the lower extremities as a leading injury resulting from a non-lethal car accident. In all cases, an expert assessment of the nature of traumatic injuries was carried out at the Kharkov Regional Bureau of Forensic Medical Examination. Reports of primary forensic medical examinations were selected by random sampling for the period February-June 2018. Inclusion criteria – isolated fractures of the femur or lower leg bones; non-lethal polytrauma with fractures of long bones of the lower extremities as a leading injury received by drivers, passengers of vehicles, pedestrians as a result of a collision with a car. Exclusion criteria – non-lethal polytrauma, in which fractures of the long bones of the lower extremities were a concomitant injury; car accident in which the forensic medical examination was carried out in terms exceeding 1 month; fractures of long bones of the lower extremities obtained as a result of other mechanisms (except for car injury), fatal car injury. Acts of primary forensic medical examinations (FMEs) were divided into 3 groups in terms of execution time. Group 1 consisted of 116 (68.2%) acts of FMEs, performed no later than 1 month after injury. Group 2 included 38 (22.4%) FMEs performed within 1 to 3 months after an accident; in group 3 – 16 (9.4%) acts of FMEs, performed after 3 months from the moment of injury. Results. A slight predominance of men (57.6%) was observed among the victims of a car accident; average age – 48.6 ± 26.2 years (10-81 years). Pedestrians predominated among the victims (135; 79.4%). As a result of road traffic accidents, mainly polytrauma (93.5%) was formed with a predominance of combined injuries (72.9%). Serious bodily injuries were found in 18.2% of examinations; bodily injuries of moderate severity – in 81.2%; minor bodily injuries – in 97.1%. In one case (0.6%), the severity of bodily injuries was not determined due to the absence of primary radiographs of fractures of the radius and shin bones. The examinations revealed injuries without the assessment of a medical forensic expert. Among them were: 1) potentially serious bodily injuries – open fractures of the diaphysis of the femur and tibia; 2) bodily injuries of potentially moderate severity – closed uncomplicated fractures of various localization (ribs, pelvis, upper and lower extremities), traumatic dislocations of the shoulder and hip joints, as well as moderate brain concussion; 3) potentially minor bodily injuries in the form of soft tissue bruises in the head and/or face, bruises of the anterior abdominal wall. Conclusions. During the primary forensic medical examination, the most typical questions were: establishing the severity of bodily injuries (100%), localization (83.5%), presence and number (78.2%) of injuries; whether the victim had alcohol and/or drug intoxication at the time of injury (75.3%); mechanism of formation (66.5%) and prescription (54.1%) of the injuries received. A study of medical records revealed no descriptions or incomplete description of soft tissue injuries, including a broken segment of the musculoskeletal system. This was one of the reasons for the failure to establish the location of the victim’s body at the time of the car injury in 3 (1.8%) cases, as well as the severity of bodily injuries in 26 (15.3%) examinations.

car injury, mechanical injury of the lower extremities, primary forensic medical examination, severity of bodily injuries.

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«Bulletin of problems biology and medicine» Issue 3 (157), 2020 year, 380-384 pages, index UDK 340.66:617.58-001

10.29254/2077-4214-2020-3-157-380-384