Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Section of Legal Medicine, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
Radiology Section, DIBIMED, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
Int J Legal Med. 2021 May;135(3):893-901. doi: 10.1007/s00414-020-02470-2. Epub 2020 Nov 25.
The motor vehicle crash (MVC) constitutes an important challenge for forensic pathology in order to identify the manner and cause of death. Our study focuses on a fatal accident during a rally race corresponding to MVC sub-category.
Postmortem computed tomography (PMCT) was performed before the conventional autopsy. Autoptic and PMCT data were compared. Data collection allowed analyzing biomechanical dynamics of the incident and post-traumatic injuries through qualitative-statistics and solicitation quantitative indices.
Photo and circumstantial evidence analysis showed a wrong installation of double shoulder belt system of head and neck support (HANS) collar. PMTC clearly highlighted multiple and bilateral fractures involving roof and base of skull; a displaced fracture of the right acetabulum was also encountered. Autopsy confirmed PMCT data and revealed a brainstem laceration. AIS (Abbreviated Injury Scale) achieved a maximum score in consideration of fatal injuries.
The injuries analysis resulting from photographic surveys examination, conventional autopsy, and PMCT has led us to confirm a fatal front collision with a tree trunk. Head trauma represents a major injury in the present case. In this case, head injuries, related to whiplash trauma, are a consequence of a double shoulder belt system (HANS collar component) wrong installation.
MVC and especially high-speed motor racing represent an important death cause. There was, for this reason, a marked development of cars and occupants' safety systems, such as HANS collar. PMCT improves the diagnostic performance of conventional autopsy and increases forensic medical knowledge related to traumatic injuries.
机动车事故（MVC）是法医病理学的一个重要挑战，目的是识别死亡方式和原因。我们的研究集中在一场拉力赛车事故，该事故属于 MVC 子类别。
在进行常规尸检之前进行了死后计算机断层扫描（PMCT）。对尸检和 PMCT 数据进行了比较。通过定性统计和征求定量指标，对数据进行了收集，以便分析事故中的生物力学动力学和创伤后损伤。
照片和环境证据分析表明，头颈部支撑（HANS）颈带的双肩部安全带系统安装错误。PMTC 清楚地突出了涉及颅骨顶部和底部的多处双侧骨折；还遇到了右侧髋臼的移位性骨折。尸检证实了 PMCT 数据，并显示了脑干撕裂。考虑到致命伤害，AIS（简明损伤量表）达到了最高评分。
摄影调查检查、常规尸检和 PMCT 的损伤分析使我们能够确认与树干的致命正面碰撞。头部创伤是本案例中的主要损伤。在这种情况下，头部损伤与挥鞭伤有关，是双肩部安全带系统（HANS 颈带组件）错误安装的结果。
MVC，特别是高速赛车，是一个重要的死亡原因。因此，汽车和乘客安全系统（如 HANS 颈带）得到了显著发展。PMCT 提高了常规尸检的诊断性能，并增加了与创伤性损伤相关的法医学知识。
