Institute of Forensic Medicine, Kantonsspital St. Gallen (KSSG), St. Gallen, Switzerland.
Int J Legal Med. 2021 Jan;135(1):213-222. doi: 10.1007/s00414-020-02428-4. Epub 2020 Sep 14.
Rib fractures are a common finding in legal medicine and information on the impact mechanism is relevant for trauma reconstruction. This study focuses on morphological characteristics of rib fractures resulting from direct or indirect force. Fresh human ribs (n = 312) were divided into two groups and broken through local force (direct) and bending (indirect) in anterolateral areas. The ribs were macerated, visually investigated and the results statistically analysed. The indirect fractures showed a significant larger lateral offset of the internal and external fracture ends while the fracture ends of the direct fractures were more often straight, in line. Also, the morphology of the inner and outer fracture edges was significantly related to fracture type. Direct fractures mostly had rough and jagged inner edges (tension side) and straight, smooth outer edges (compression side), whereas indirect fractures more often showed the characteristics vice versa. The results were more convincing in combination and in ribs from persons aged ≤ 75 years at death. In summary, the direct and indirect rib fractures showed significantly different characteristics regarding orientation and offset of the fracture lines and roughness of the inner and outer fracture edges, which can be helpful to distinguish the traumatizing impact mechanisms in forensic autopsy routine.
肋骨骨折在法医学中较为常见，了解致伤机制对创伤重建具有重要意义。本研究专注于直接或间接暴力导致的肋骨骨折的形态学特征。新鲜人肋骨（n=312）分为两组，通过前外侧区域的局部力（直接）和弯曲（间接）折断。肋骨经过浸软、肉眼观察和统计分析。间接骨折中外侧骨折端的明显较大的横向偏移，而直接骨折端的骨折端更经常是直的，成一直线。此外，骨折内缘和外缘的形态与骨折类型有显著的关系。直接骨折的内缘多粗糙、锯齿状（张力侧），外缘较直、光滑（压缩侧），而间接骨折则更多地表现出相反的特征。在结合和死亡时年龄≤75 岁的肋骨中，结果更具说服力。总之，直接和间接肋骨骨折在骨折线的方向和偏移以及骨折内缘和外缘的粗糙度方面具有显著不同的特征，这有助于在法医尸检常规中区分致伤机制。
