Investigating reverse butterfly fractures: An experimental approach and application of fractography

Detection of butterfly fractures of long bones through multi-slice computed tomography and micro-computed tomography

Motor-vehicle accidents often result in lower limb injuries with biosseous fractures. The present study aimed at comparing multi-slice computed tomography (MS-CT), micro-computed tomography (micro-CT) and external fractography for the analyses of experimentally produced biosseus leg fractures. Briefly, 48 human legs amputated for medical reasons were defleshed and then experimentally fractured using a 3-point dynamic bending model (70,6 J of impact energy at the middle of the anterior surface of the tibia) producing 38 biosseous and 10 mono-osseous fractures with a total of 86 fractured bones. External fractography detected 63 (73,2%) "butterfly" fractures (24 (27,9%) complete and 39 (45,3%) incomplete), 14 (16,3%) "oblique" fractures, 6 (7,0%) "comminuted" fractures and 3 (3,5%) "transverse" fractures. Forty-three (43) of the 48 included legs displayed at least one butterfly fracture located at the tibia or fibula. MS-CT correctly detected and classified 16 complete and 20 incomplete butterfly fractures, failing to properly classify 27 fractures; 19 of these misclassifications led to an interpretative error on the trauma direction (i.e., 16 incomplete butterfly fractures classified as oblique fractures and 3 incomplete butterfly fractures classified as transverse). Micro-CT correctly detected and classified 22 complete and 37 incomplete butterfly fractures, failing to properly classify 4 fractures; two of these misclassifications led to an interpretative error on the trauma direction (i.e., two incomplete butterfly fractures classified as oblique fractures). Although further studies evaluating a wider number of fractures and fracture patterns are required to drive any definitive conclusions, this preliminary experimental investigation showed that MS-CT and micro-CT represent useful tools for reconstructing the morphology of leg fractures and could be crucial for trauma analysis in the forensic context. MS-CT could be used as a screening tool, micro-CT as second level analysis and external/internal fractography as third level, confirmatory analysis.

Effects of kinetic energy and firearm-to-target distance on fracture behavior in flat bones

This research implements a fractographic approach to investigate the relationships between kinetic energy, firearm-to-target distance, and various aspects of fracture behavior in gunshot trauma. Gunshot experiments were performed on pig scapulae (n = 30) using three firearms generating different muzzle (initial) kinetic energies, including a 0.32 pistol (103 J), 0.40 pistol (492 J), and 0.308 rifle (2275 J). Specimens were shot from two distances: 10 cm (n = 15) and 110 cm (n = 15). Features evaluated in fractographic analysis such as cone cracks, radiating cracks, crack branching points, and circumferential cracks could be easily identified and measured in flat bones and allowed for statistical comparison of crack propagation behavior under different impact conditions. Higher-energy bullets produced more radiating cracks, more crack branching points, and longer fracture lengths than lower-energy bullets. Distance had no significant effect on fracture morphology at the distances tested. That quantitative measures of crack propagation varied with energy affirms that kinetic energy transfer is important in determining the nature and extent of fracture in gunshot wounds and suggests it may be possible to infer relatively high- versus relatively low-energy transfer using these features. Ranges obtained with the three firearms exhibited considerable overlap, however, indicating that other variables such as bullet caliber, mass, and construction influence the efficiency of energy transfer from bullet to bone. Therefore, fracture morphology cannot be used to identify a specific firearm or to directly reconstruct the muzzle (initial) kinetic energy in forensic cases.

Chronic fracture and osteomyelitis in a large-bodied ornithomimosaur with implications for the identification of unusual endosteal bone in the fossil record

Paleopathological diagnoses provide key information on the macroevolutionary origin of disease as well as behavioral and physiological inferences that are inaccessible via direct observation of extinct organisms. Here we describe the external gross morphology and internal architecture of a pathologic right second metatarsal (MMNS VP-6332) of a large-bodied ornithomimid (~432 kg) from the Santonian (Upper Cretaceous) Eutaw Formation in Mississippi, using a combination of X-ray computed microtomography (microCT) and petrographic histological analyses. X-ray microCT imaging and histopathologic features are consistent with multiple complete, oblique to comminuted, minimally displaced mid-diaphyseal cortical fractures that produce a "butterfly" fragment fracture pattern, and secondary osteomyelitis with a bone fistula formation. We interpret this as evidence of blunt force trauma to the foot that could have resulted from intra- or interspecific competition or predator-prey interaction, and probably impaired the function of the metatarsal as a weight-bearing element until the animal's death. Of particular interest is the apparent decoupling of endosteal and periosteal pathological bone deposition in MMNS VP-6332, which produces transverse sections exhibiting homogenously thick endosteal pathological bone in the absence of localized periosteal reactive bone. These distribution and depositional patterns are used as criteria for ruling out a pathological origin in favor of a reproductive one for unusual endosteal bone in fossil specimens. On the basis of MMNS VP-6332, we suggest caution in their use to substantiate a medullary bone identification in extinct archosaurians.