Delannoy Yann, Becart Anne, Colard Thomas, Delille Rémi, Tournel Gilles, Hedouin Valéry, Gosset Didier
Institut de Médecine Légale (Unité de Taphonomie), Faculté de Médecine, Université Lille Nord de France - CHRU de Lille, place de Verdun, 59045 Lille Cedex, France.
Leg Med (Tokyo). 2012 Sep;14(5):258-62. doi: 10.1016/j.legalmed.2012.04.006. Epub 2012 Jun 7.
The lesions of the skull following perforating traumas can create complex fractures. The blunt traumas can, according to the swiftness and the shape of the object used, create a depressed fracture. The authors describe through two clinical cases the lesional characteristic of the blunt traumas, perforating the skull using a hammer. In both cases the cranial lesions were very typical: they were geometrical, square shaped, of the same size than the tool (head and tip of the hammer). On the outer table of the skull, the edges of the wounds were sharp and regular. On the inner table, the edges of the wounds were beveled and irregular. The bony penetration in the depressed fracture results from a rupture of the outer table of the bone under tension, in periphery, by the bend of the bone to the impact (outbending) and then, from the inner table with comminuted bony fragmentation. Breeding on the fractures of the size and the shape of the blunt objects used is inconstant and differs, that it is the objects of flat surface or wide in opposition to those of small surface area. Fractures morphologies depend on one hand on these extrinsic factors and on the other hand, of intrinsic factors (structure of the bone). To identify them, we had previously conducted experimental work on cranial bone samples. The bone was submitted to a device for three-point bending. This work had shown properties of thickness and stiffness of the various areas of the vault. Our cases are consistent with these results and illustrate the variability of bone lesions according to region and mode of use of blunt weapons. Many studies have identified criteria for identification of the weapons and the assistance of digital and biomechanical models will be an invaluable contribution with this aim in the future.
颅骨穿通伤后的损伤可造成复杂骨折。钝器伤可根据所用物体的速度和形状造成凹陷性骨折。作者通过两个临床病例描述了用锤子穿通颅骨的钝器伤的损伤特征。在这两个病例中，颅骨损伤都非常典型：它们呈几何形状，方形，与工具（锤子头部和尖端）大小相同。在颅骨外板上，伤口边缘锋利且规则。在内板上，伤口边缘呈斜面且不规则。凹陷性骨折中的骨质穿透是由于骨外板在张力作用下于周边因骨向撞击方向弯曲（向外弯曲）而破裂，然后内板出现粉碎性骨碎片。根据所用钝器的大小和形状在骨折处的繁殖情况并不恒定且存在差异，平面或大面积物体与小面积物体的情况不同。骨折形态一方面取决于这些外在因素，另一方面取决于内在因素（骨结构）。为了识别它们，我们之前对颅骨样本进行了实验研究。将骨头置于三点弯曲装置中。这项研究显示了颅顶不同区域的厚度和刚度特性。我们的病例与这些结果一致，并说明了根据钝器使用区域和方式不同，骨损伤存在变异性。许多研究已经确定了识别武器的标准，数字和生物力学模型的辅助在未来将对此目标做出宝贵贡献。
