OBJECTIVE: To investigate the main point of long backbone fracture caused by blunt force in forensic clinical identification and to provide a reference for the inspection and appraisal practices of such injury. METHODS: Ninety-nine cases of adult long backbone fractures were collected from January 2006 to December 2013 in Gutian County of Fujian Province. According to the terms of fracture location, mode of injury, type, the data were summarized. RESULTS: In the 99 cases, there were 36 cases caused by hitting, kicking, and falling and 63 cases caused by vehicle collision. The majority of the former was ulna, and those of the latter were tibia and fibula. The types of fracture were transverse one, short oblique one, long oblique one, and spiral one. CONCLUSION Different types of long backbone fracture, not only causing stress load of fractures as well as structural differences related to each segment.
Fibula/pathology* ; Forensic Pathology ; Fractures, Bone/pathology* ; Humans ; Tibial Fractures/pathology*

Animals ; Biomechanical Phenomena ; Bone Development ; Bone Remodeling ; Bone and Bones ; injuries ; Fracture Healing ; physiology ; Fractures, Bone ; pathology

In recent years, cases of child abuse that result in injuries and death have occurred from time to time in China, and there may be more undetected child abuse cases. However, many pediatricians and forensic doctors lack professional knowledge and formal training in detecting child abuse, which leads to the missed diagnosis, misdiagnosis and misidentification of many cases of child abuse. This paper reviews a large number of relevant domestic and foreign literatures, combined with practical work experience and China's national conditions, preliminarily summarizes the main points of clinical diagnosis and forensic identification of child abuse cases, in order to provide some help for early detection, accurate identification of child abuse cases and timely and effective treatment and protection for abused children.
Child ; Child Abuse ; China ; Forensic Pathology ; Fractures, Bone ; Humans ; Skin

OBJECTIVE: To explore the key points of injury mechanism of scaphoid fracture in forensic expertise and to provide the references for forensic practices. METHODS: Forty-three cases of injury mechanism identification of scaphoid fracture were selected from 2007 to 2011 in Institute of Forensic Evidence, Chinese Criminal Police Academy. Following aspects were analyzed: missed diagnosis and misdiagnosis at first visit, fracture classifications, accompanying injuries and mechanism of injury. RESULTS: The rates of missed diagnosis and misdiagnosis were high in the cases of scaphoid fractures, most common in the fracture of the waist. The disagreement on mechanism of injury was whether it was due to direct impact or indirect effect by falling. CONCLUSION Wrist hyperextension due to fall with palm impact on the ground was the main cause of scaphoid fracture.
Diagnostic Errors ; Forensic Pathology ; Fractures, Bone ; Humans ; Scaphoid Bone/injuries* ; Wrist Injuries ; Wrist Joint

Based on the CT data and the structure characteristics of the femoral fractures during different healing stages, medical FE models of fractured femur treated with locking compression plate (LCP)were built. Under the physiological load of a standard body weight (70 kg) and the constraint condition, the stress distributions of LCP and fractured femur during healing were calculated by means of three-dimensional finite element analysis (3D-FEA). The results showed that the stress distribution in the LCP and the fractured femur was similar, during the initial stage which there was no newly formed bone or soft tissue in fracture site. The maximum von Mises stress (371.23,272.76 MPa) in the fractured femur was much higher than that in natural femur, and the intensive stress was concentrated mainly in the proximal area of the fractured femur. With the growth of bony callus bone in fracture site, the intensity of stress in proximal femur decreased. Contrasted to the two cases mentioned above, the value of the maximum von Mises stress (68. 17 MPa) in bony callus bone stage decreased significantly, and was lower than the safe strength of natural bone. Therefore, appropriate training which is benefitial for the growth to new bone could be arranged for the better rehabilitation.
Biomechanical Phenomena ; Bone Plates ; Femoral Fractures ; pathology ; Femur ; pathology ; Finite Element Analysis ; Humans ; Stress, Mechanical

Nowdays, it is common seen that criminals tend to use the lock-against-theft for motorcycle to harm others as a tool. In order to find out the chief characters of this kind of injury, 28 cases in which victims were hurt by lock-against-theft for motorcycle were analyzed. In each case, the victims carefully questioned to confirm the damage procedure. Furthermore, the wound configuration was observed and the forming mechanism was deduced to provide morphological evidences for the judgement in this kind of case.
Female ; Forensic Medicine ; Fractures, Bone/pathology* ; Humans ; Male ; Motorcycles ; Skin/pathology* ; Violence ; Wounds and Injuries/pathology* ; Wounds, Nonpenetrating/pathology*

PURPOSE: The purpose of this study was a phantom study to measure the diffusion properties of water molecules by steady-state free precession diffusion-weighted imaging (SSFP-DWI) with a low b-value and to determine if this sequence might be useful for application to the evaluation of bone marrow pathology. MATERIALS AND METHODS: 1. The phantom study: A phantom study using two diffusion weighted sequences for the evaluation of the diffusion coefficient was performed. Three water-containing cylinders at different temperatures were designed: phantom A was 3degrees C, B was 23degrees C and C was 63degrees C. Both SSFP and echo planar imaging (EPI) sequences (b-value: 1000 s/mm2) were performed for comparison of the diffusion properties. The Signal to noise ratios (SNR) and apparent diffusion coefficient (ADC) values of the three phantoms using each diffusion-weighted sequence were assessed. 2. The Clinical study: SSFP-DWI was performed in 28 patients [sacral insufficiency fractures (10), osteoporotic lumbar compression fractures (10), malignant compression fractures (8)]. To measure the ADC maps, a diffusion-weighted single shot stimulated echo-acquisition mode sequence (650s/ mm2) was obtained using the same 1.5-T MR imager RESULTS: For the phantom study, the signal intensity on the SSFP as well as the classic EPI-based DWI was decreased as the temperature increased in phantom A to C. The ADC values of the phantoms on EPI-DWI were 0.13x10(-3) mm2/s in phantom A, 0.22x10(-3) mm2/s in B and 0.37x10(-3) mm2/s. in C. The SSFP can be regarded as a DWI sequence in view of the series of signal decreases. CONCLUSION: Bone marrow pathologies with different diffusion coefficients were evaluated by SSFP-DWI. All benign fractures were hypointense compared to the adjacent normal bone marrow where as the malignant fractures were hyperintense compared to the adjacent normal bone marrow.
Bone Marrow* ; Diffusion ; Echo-Planar Imaging ; Fractures, Compression ; Fractures, Stress ; Humans ; Pathology* ; Signal-To-Noise Ratio ; Spine ; Water

Bone is a load-bearing organ in human body. Fatigue damage occurs readily at the modest loads to which bone is subjected during its habitual physiological usage. Even bone fracture may occur during vigorous activity. The nature of fatigue damage is that in bone there are very fine microcracks which are smaller than typical microcracks, and may occur at the level of hydroxyapatite crystals. But bone can repair microdamage by bone remodeling. Osteocytes play an important role of signaling during bone remodeling. Some researchers attempted to describe the process of bone fatigue damage and repair by mathematic, mechanical models in order to understand it well and to apply it well in clinical practice.
Animals ; Bone Remodeling ; physiology ; Bone Resorption ; pathology ; physiopathology ; Bone and Bones ; cytology ; injuries ; physiology ; Fractures, Stress ; pathology ; physiopathology ; Humans ; Models, Biological ; Stress, Mechanical

OBJECTIVETo discuss the reasons and the treatments for the femoral refracture.

METHODSFrom 2004 to 2008, 10 cases of femoral refracture after plate removal were selected and treated with open reduction and bone nail internal fixation, included 4 males and 6 females ranging from 19 to 48 years with an average age of 33 years old. According to Müller classification, there were 4 cases of type A, 3 of B, 3 of C. The skeletal tissues were taken for pathological analysis.

RESULTSTen patients were followed-up for 10 to 18 months (averaged 14 months). All wound healed at one stage,there were no complications. The fuction of lower limbs walking and weight loading werer recovered. Pathological section showed that part of the lamellar bone tissues were necrotic. The bone architectures were chaotic, micrangium blocked, Haversian canals were atrophy, new vessels and Haversian canals growed in necrotic bone. The tunnel in rigid bone and new Haversian system were formed. The structure was cutting cone. It was the process of new bone substitutting necrotic bone in bony remodeling.

CONCLUSIONThe internal fixation using ordinary plates overwhelmingly destroy blood circulation of bone and cause necrosis of bone. It can also effect bone remodeling and descent mechanical property. Refracture can readily happen after the plate removal. Treatment of open reduction and bone nail internal fixation can achieve excellent and good effect.

Adult ; Bone Plates ; Female ; Femoral Fractures ; pathology ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Recurrence

Occurance of atrophic nonunion is a complex process. Previous studies suggested that atrophic nonunion was mainly due to lack of blood supply of fracture fragments, but recent studies found that blood supply was not deficiency in middle and late stages, indicating that decreased osteogenic factors and blood supply in early stages might play an important role in morbidity. Current effective treatment measures for atrophic nonunion mainly include bone graft and fixation,physical therapy, local injection therapy. All-round preventive could reduce incidence of atrophic nonunion. Atrophic nonunion is still a troublesome complication of fractures in orthopaedics, and more attention should be paid for its effective prevention and treatment. The paper summarized recent original articles about atrophic nonunion and reviewed the occurrence mechanisms, diagnosis, prevention and treatment measures of this disease.
Atrophy ; diagnosis ; etiology ; prevention & control ; therapy ; Fracture Healing ; drug effects ; Fractures, Bone ; pathology ; Humans