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创伤后颅骨修复与再生:法医学及临床法医学后果

Cranial Bone Repair and Regeneration After Trauma: Forensic and Clinical Medico-Legal Consequences.

作者信息

Hostiuc Sorin, Negoi Ionuț, Ciocan Veronica

机构信息

Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Department of Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

出版信息

Bioengineering (Basel). 2025 Aug 26;12(9):915. doi: 10.3390/bioengineering12090915.

Abstract

Cranial bone defects caused by trauma present significant clinical challenges but also difficulties in their forensic analysis. The complexity of cranial anatomy, limited vascularization, and proximity to neural structures complicate natural bone regeneration, often requiring surgical intervention and the use of complex materials and techniques. This review aims to identify relevant data for forensic analysis regarding bone regeneration after trauma, with an emphasis on the materials used and their interpretation in medico-legal contexts. It moves beyond a simple clinical perspective, providing a detailed medico-legal analysis of cranial bone repair and regeneration after trauma. This review aims to give a comprehensive analysis of the forensic and medico-legal consequences associated with cranial reconstruction using autogenic, allogenic, xenogenic, and synthetic materials. It gives a pioneering focus regarding an understudied but critical aspect of forensic and legal medicine, both to postmortem and to clinical elements. By detailing the unique radiographic signatures and physical characteristics of various reconstruction materials, we provide the specialists with a go-to material for the interpretation of these materials in forensic contexts. Furthermore, we will provide a detailed analysis of medico-legal risks, mainly those associated with malpractice claims, focusing our attention on the process of informed consent but also the management and interpretation of surgery-related complications.

摘要

创伤导致的颅骨缺损不仅给临床带来重大挑战,也给法医分析带来困难。颅骨解剖结构的复杂性、有限的血管化以及与神经结构的接近程度使自然骨再生变得复杂,通常需要手术干预以及使用复杂的材料和技术。本综述旨在确定创伤后骨再生的法医分析相关数据,重点关注所用材料及其在法医学背景下的解读。它超越了简单的临床视角,对创伤后颅骨修复和再生进行了详细的法医学分析。本综述旨在全面分析使用自体、异体、异种和合成材料进行颅骨重建所带来的法医和法医学后果。它率先关注了法医学和法律医学中一个虽未得到充分研究但至关重要的方面,包括死后和临床因素。通过详细阐述各种重建材料独特的放射学特征和物理特性,我们为专家提供了一种在法医背景下解读这些材料的实用资料。此外,我们将详细分析法医学风险,主要是与医疗事故索赔相关的风险,重点关注知情同意过程以及手术相关并发症的管理和解读。

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