Objective skull fracture evaluation by using the postmortem 3D-CT skull fracture score in fatal falls
Copyright © 2022 Elsevier B.V. All rights reserved..
PURPOSE: We evaluated the usefulness of skull fracture analysis using three-dimensional computed tomography skull fracture scores (3DCT-SFs) in cases of fatal falls.
MATERIALS AND METHODS: From April 2016 to September 2020, 46 cases of fatal falls from great heights (33 males, 13 females; mean age: 52.7 (range: 18-89) years) were examined using routine postmortem CT. The 3DCT-SFs were determined as the sum of the fracture line lengths measured on a volume rendering image. Skull fracture severity was classified into four stages according to the 3DCT-SFs. These stages were compared by macroscopic evaluation of skull fracture severity (injury level 0: no fracture; injury level I: fracture without deviation; injury level II: fracture with deviation; injury level III: comminuted open skull fracture). The relationship between 3DCT-SFs values, the fall distance, and the hardness of the landing surface was also examined.
RESULTS: Skull fractures occurred in 26 cases (56.5%). The mean 3DCT-SFs of the cases that were classified as stages I, Ⅱ, and III were 86.6 (5.0-187.0), 832.0 (235.1-1865.8), and 3582.5 (2171.6-4787.6), respectively. Upon macroscopic evaluation of fracture severity, there were 8, 10, and 8 cases of injury levels I, II, and III, respectively. The 3DCT-SFs-based stages correlated significantly with the macroscopic skull fracture severity levels (R2 = 0.936). Solid-surface fall points resulted in significantly higher 3DCT-SFs than soft surfaces. Comminuted open fracture of the skull (stage III) occurred with fall distances ≥ 24 m.
CONCLUSION: The 3DCT-SFs correlate well with macroscopic findings and are useful as an objective skull fracture index.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:56 |
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| Enthalten in: |
Legal medicine (Tokyo, Japan) - 56(2022) vom: 15. Mai, Seite 102048 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hyodoh, Hideki [VerfasserIn] |
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| Links: |
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| Themen: |
3D reconstruction |
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| Anmerkungen: |
Date Completed 18.04.2022 Date Revised 18.04.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.legalmed.2022.102048 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM33762979X |
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| 500 | |a Date Revised 18.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier B.V. All rights reserved. | ||
| 520 | |a PURPOSE: We evaluated the usefulness of skull fracture analysis using three-dimensional computed tomography skull fracture scores (3DCT-SFs) in cases of fatal falls | ||
| 520 | |a MATERIALS AND METHODS: From April 2016 to September 2020, 46 cases of fatal falls from great heights (33 males, 13 females; mean age: 52.7 (range: 18-89) years) were examined using routine postmortem CT. The 3DCT-SFs were determined as the sum of the fracture line lengths measured on a volume rendering image. Skull fracture severity was classified into four stages according to the 3DCT-SFs. These stages were compared by macroscopic evaluation of skull fracture severity (injury level 0: no fracture; injury level I: fracture without deviation; injury level II: fracture with deviation; injury level III: comminuted open skull fracture). The relationship between 3DCT-SFs values, the fall distance, and the hardness of the landing surface was also examined | ||
| 520 | |a RESULTS: Skull fractures occurred in 26 cases (56.5%). The mean 3DCT-SFs of the cases that were classified as stages I, Ⅱ, and III were 86.6 (5.0-187.0), 832.0 (235.1-1865.8), and 3582.5 (2171.6-4787.6), respectively. Upon macroscopic evaluation of fracture severity, there were 8, 10, and 8 cases of injury levels I, II, and III, respectively. The 3DCT-SFs-based stages correlated significantly with the macroscopic skull fracture severity levels (R2 = 0.936). Solid-surface fall points resulted in significantly higher 3DCT-SFs than soft surfaces. Comminuted open fracture of the skull (stage III) occurred with fall distances ≥ 24 m | ||
| 520 | |a CONCLUSION: The 3DCT-SFs correlate well with macroscopic findings and are useful as an objective skull fracture index | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a 3D reconstruction | |
| 650 | 4 | |a Fatal falls | |
| 650 | 4 | |a Postmortem computed tomography | |
| 650 | 4 | |a Skull fracture | |
| 650 | 4 | |a Volume rendering | |
| 700 | 1 | |a Takeuchi, Akiko |e verfasserin |4 aut | |
| 700 | 1 | |a Matoba, Kotaro |e verfasserin |4 aut | |
| 700 | 1 | |a Murakami, Manabu |e verfasserin |4 aut | |
| 700 | 1 | |a Matoba, Tomoko |e verfasserin |4 aut | |
| 700 | 1 | |a Saito, Atsuko |e verfasserin |4 aut | |
| 700 | 1 | |a Jin, Shigeki |e verfasserin |4 aut | |
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