Wulff Alexandra, Dipnall Joanna F, Fernandez Richard G D, Cheshire Emma C, Biggs Michael J P, de Boer Hans, Rowbotham Samantha K
Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, VIC, 3006, Australia.
Clinical Registries, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
Int J Legal Med. 2025 Mar;139(2):901-915. doi: 10.1007/s00414-024-03372-3. Epub 2024 Nov 23.
Globally, thousands of truck occupants die annually from motor vehicle incidents. During medico-legal investigations of such incidents, forensic practitioners are required to undertake thorough examinations of the injuries present. Despite this, very few studies assessing skeletal fractures in particular, in deceased truck occupants are currently available in the literature for practitioners. Consequently, this research aimed to investigate the whole-body skeletal fracture patterns resulting from fatal truck incidents. The study group comprised 62 adult truck occupants who died in motor vehicle incidents between 2006 and 2020 and were examined at the Victorian Institute of Forensic Medicine, Australia, and the East Midlands Forensic Pathology Unit, United Kingdom. Available intrinsic and extrinsic variable information was extracted from medico-legal reports and fracture patterns were documented using associated post-mortem computed tomography scans. Descriptive and basic inferential statistics were performed to analyse the pattern and extent of fracturing, and where possible, the role of variables. The study found 97% of occupants exhibited skeletal blunt force trauma, with 94% fracturing multiple anatomical regions. The thorax (85%), followed by the skull (63%) and cervical vertebrae (56%) comprised the most fractured and fragmented skeletal regions, whilst the upper limb (23%) and pelvic girdle (31%) were fractured least often. The variables body mass index, impact velocity and truck type were associated with fracture patterning. This research provides medico-legal investigators with a greater evidence base of the fracture patterns that result from fatal truck incidents, including the patterning, complexity and quantity of fracturing, and the potential mechanisms behind them.
在全球范围内，每年都有成千上万的卡车驾乘人员死于机动车事故。在对此类事故进行法医学调查时，法医从业者需要对伤者进行全面检查。尽管如此，目前文献中可供从业者参考的评估已故卡车驾乘人员骨骼骨折情况，尤其是骨骼骨折的研究却非常少。因此，本研究旨在调查致命卡车事故导致的全身骨骼骨折模式。研究组包括62名成年卡车驾乘人员，他们于2006年至2020年间死于机动车事故，并在澳大利亚维多利亚法医研究所和英国东米德兰法医病理科接受了检查。从法医学报告中提取了可用的内在和外在变量信息，并使用相关的尸检计算机断层扫描记录骨折模式。进行描述性和基本推断性统计以分析骨折的模式和程度，并在可能的情况下分析变量的作用。研究发现，97%的驾乘人员表现出骨骼钝器伤，94%的人在多个解剖区域发生骨折。胸部（85%），其次是颅骨（63%）和颈椎（56%）是骨折和破碎最严重的骨骼区域，而上肢（23%）和骨盆带（31%）骨折最少见。体重指数、撞击速度和卡车类型等变量与骨折模式有关。这项研究为法医学调查人员提供了更丰富的证据基础，以了解致命卡车事故导致的骨折模式，包括骨折的模式、复杂性和数量，以及其背后的潜在机制。
