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Li R, Su Z, Li Z, Li D, Luo R, Qiu J, Lan H. Experimental investigation of brain contusion characteristics and dynamic response in low-age children using an animal model. Injury 2024; 55:111589. [PMID: 38704918 DOI: 10.1016/j.injury.2024.111589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/11/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Brain contusion is a prevalent traumatic brain injury (TBI) in low-age children, bearing the potential for coma and fatality. Hence, it is imperative to undertake comprehensive research in this field. METHODS This study employed 4-week-old piglets as surrogates for children and introduced self-designed devices for both free-fall drop impact tests and drop-hammer impact tests. The study explored the characteristics of brain contusion and dynamic responses of brain under these distinct testing conditions. RESULTS Brain contusions induced by free-fall and drop-hammer conditions both were categorized as the coup injury, except that slight difference in the contusion location was observed, with contusion occurring mainly in the surrounding regions beneath the impact location under free-fall condition and the region just right beneath the impact location under drop-hammer condition. Analysis of impact force and intracranial pressure (ICP) curves indicated similar trends in impact forces under both conditions, yet different trends in ICPs. Further examination of the peak impact forces and ICPs elucidated that, with increasing impact energy, the former followed a combined power and first-order polynomial function, while the latter adhered to a power function. The brain contusion was induced at the height (energy) of 2 m (17.2 J), but not at the heights of 0.4, 0.7, 1, 1.35 and 1.7 m, when the vertex of the piglet head collided with a rigid plate. In the case of a cylindrical rigid hammer (cross-sectional area constituting 40 % of the parietal bone) striking the head, the brain contusion was observed under the energy of 21.9 J, but not under energies of 8.1 J, 12.7 J and 20.3 J. Notably, the incidence of brain contusion was more pronounced under the free-fall condition. CONCLUSIONS These findings not only facilitate a comprehensive understanding of brain contusion dynamics in pediatric TBIs, but also contribute to the validation of theories and finite element models for piglet heads, which are commonly employed as surrogates for children.
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Affiliation(s)
- Rui Li
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, 100044, PR China
| | - Zhongqing Su
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, 100044, PR China
| | - Zhigang Li
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, 100083, PR China.
| | - Dapeng Li
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, PR China
| | - Rutao Luo
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, PR China
| | - Jinlong Qiu
- Daping Hospital of Army Medical University, PLA, 400042, PR China
| | - Huiqing Lan
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, 100044, PR China
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2
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O'Hara MA, Valvano TJ, Kashyap M, Daly JC, Bachim AN, Care MM, Egge MK, Kondis JS, Lenane AM, Maddocks ABR, Metz JB, Nielsen AK, Reeder KN, Ruda MT, Segal R, Sugarman JM, Weeks K, Oral R. Understanding Bilateral Skull Fractures in Infancy: A Retrospective Multicenter Case Review. Pediatr Emerg Care 2023; 39:329-334. [PMID: 35413039 DOI: 10.1097/pec.0000000000002704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bilateral skull fractures in infancy often raise suspicion for abuse. Nevertheless, literature suggests that they may occur accidentally. However, empiric data are lacking. OBJECTIVE This multicenter retrospective review aimed to characterize bilateral skull fractures in a large sample. PARTICIPANTS AND SETTING Medical records for infants younger than 24 months with bilateral skull fractures involving hospital consultation with a child abuse pediatrician (CAP) were reviewed from 2005 to 2020 at 13 nationally represented institutions. METHODS Standardized data collection across institutions included historical features, fracture characteristics, and additional injuries, as well as the CAP's determination of accident versus abuse. Pooled data were analyzed for descriptive and bivariate analyses. RESULTS For 235 cases, 141 were accidental, and 94 abuse. The majority occurred in young infants, and a history of a fall was common in 70% of cases. More than 80% involved both parietal bones. Bilateral simple linear fractures were more common in accidental cases, 79% versus 35%, whereas a complex fracture was more frequent in abuse cases, 55% versus 21% ( P < 0.001). Almost two thirds of accidental cases showed approximation of the fractures at the sagittal suture, compared with one third of abuse cases ( P < 0.001). Whereas focal intracranial hemorrhage was seen in 43% of all cases, diffuse intracranial hemorrhage was seen more in abuse cases (45%) than accidents (11%). Skin trauma was more common in abusive than accidental injury (67% vs 17%, P < 0.001), as were additional fractures on skeletal survey (49% vs 3%, P < 0.001). CONCLUSIONS A fall history was common in bilateral skull fractures deemed accidental by a CAP. Most accidental cases involved young infants with biparietal simple linear fractures, without skin trauma or additional fractures. A skeletal survey may aid in the determination of accidental or abusive injury for unwitnessed events resulting in bilateral skull fractures in infants.
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Affiliation(s)
| | - Thomas J Valvano
- Department of Pediatrics, Oregon Health and Science University, Portland, OR
| | - Marisha Kashyap
- Mailman School of Public Health, Columbia University, New York, NY
| | - Jennie C Daly
- Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda, CA
| | - Angela N Bachim
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
| | - Marguerite M Care
- Department of Radiology and Medical Imaging, Cincinnati Children's Medical Center, Cincinnati, OH
| | - Melissa K Egge
- Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda, CA
| | - Jamie S Kondis
- Department of Pediatrics, St. Louis Children's Hospital, St. Louis, MO
| | - Ann M Lenane
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY
| | - Alexis B R Maddocks
- Department of Radiology, New York-Presbyterian Hospital, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
| | - James B Metz
- Department of Pediatrics, University of Vermont Children's Hospital, Burlington, VT
| | - Anne K Nielsen
- Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA
| | - Kristen N Reeder
- Department of Pediatrics, UT Southwestern Medical Center, Dallas
| | - Michelle T Ruda
- Department of Pediatrics, University of Texas Health Science Center, Houston, TX
| | - Rachel Segal
- Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA
| | - Jacqueline M Sugarman
- Department of Pediatrics, Kentucky Children's Hospital, University of Kentucky, Lexington, KY
| | - Kerri Weeks
- Department of Pediatrics, Wesley Children's Hospital, Wichita, KS
| | - Resmiye Oral
- Department of Pediatrics, Children's Hospital at Dartmouth, Lebanon, NH
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Su ZQ, Li DP, Li R, Wang GL, Liu L, Wang YF, Guo YZ, Li ZG. Development and global validation of a 1-week-old piglet head finite element model for impact simulations. Chin J Traumatol 2022:S1008-1275(22)00081-5. [PMID: 35985904 DOI: 10.1016/j.cjtee.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/21/2022] [Accepted: 07/08/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Child head injury under impact scenarios (e.g. falling, vehicle crashing, etc.) is an important topic in the field of injury biomechanics. The head of piglet was commonly used as the surrogate to investigate the biomechanical response and mechanisms of pediatric head injuries because of the similar cellular structures and material properties. However, up to date, piglet head models with accurate geometry and material properties, which have been validated by impact experiments, are seldom. We aimed to develop such a model for future research. METHODS In this study, first, the detailed anatomical structures of the piglet head, including the skull, suture, brain, pia mater, dura mater, cerebrospinal fluid, scalp, and soft tissue, were constructed based on CT scans. Then, a structured butterfly method was adopted to mesh the complex geometries of the piglet head to generate high-quality elements and each component was assigned corresponding constitutive material models. Finally, the guided drop tower tests were conducted and the force-time histories were ectracted to validate the piglet head finite element model. RESULTS Simulations were conducted on the developed finite element model under impact conditions and the simulation results were compared with the experimental data from the guided drop tower tests and the published literature. The average peak force and duration of the guide drop tower test were similar to that of the simulation, with an error below 10%. The inaccuracy was below 20%. The average peak force and duration reported in the literature were comparable to those of the simulation, with the exception of the duration for an impact energy of 11 J. The results showed that the model was capable to capture the response of the pig head. CONCLUSION This study can provide an effective tool for investigating child head injury mechanisms and protection strategies under impact loading conditions.
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Affiliation(s)
- Zhong-Qing Su
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, 100044, China
| | - Da-Peng Li
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Rui Li
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, 100044, China
| | - Guang-Liang Wang
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, 100044, China
| | - Lang Liu
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, 100044, China
| | - Ya-Feng Wang
- Aviation Key Laboratory of Science and Technology on Structures Impact Dynamics, China Aircraft Strength Research Institute, Xi'an, 710065, China
| | - Ya-Zhou Guo
- Aviation Key Laboratory of Science and Technology on Structures Impact Dynamics, China Aircraft Strength Research Institute, Xi'an, 710065, China
| | - Zhi-Gang Li
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, 100044, China.
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Spies AJ, Steyn M, Brits D. Diagnostic accuracies of CTs, X-rays and Lodox to detect blunt force trauma in adults, using a pig model. MEDICINE, SCIENCE, AND THE LAW 2022; 62:134-143. [PMID: 34825618 DOI: 10.1177/00258024211049591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The accurate radiological detection of skeletal trauma is crucial for the investigation of blunt force trauma (BFT) cases. The sensitivities of CTs, X-rays and Lodox in identifying BFT fractures and minimum number of impacts in pigs, used as proxies for adult humans, were assessed. Ten human sized pig carcasses were struck with a mallet and scanned, after which the number of fractures and minimum number of impacts detected radiologically were recorded. Pig carcasses were then macerated, and the defleshed, skeletonized remains were considered the gold standard as far as number and location of fractures were concerned. CTs were most sensitive in identifying fractures and impacts in all body regions, with overall sensitivities of 55.4% and 71.5% respectively, while X-rays and Lodox had sensitivities of 25.8% and 29.3% for fractures, and 43.5% and 41.1% for impacts, respectively. All modalities were highly specific for identifying fractures (CT: 99.1%; X-ray: 98.9%; Lodox: 99.4%). CTs should be used to analyze blunt force trauma when a radiological assessment is required, but an examination of the defleshed bones remains the gold standard for the deceased whenever feasible. X-rays and Lodox have limited diagnostic value in these cases and relying on them to detect fractures may compromise the accurate forensic investigation of blunt trauma victims. However, the use of Lodox for initial screening of major trauma is still of value. Sensitivities are generally higher for detecting fractures in pigs compared to piglets, indicating that increased diagnostic value is achieved when imaging pigs compared to piglets.
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Affiliation(s)
- Amy Joy Spies
- Human Variation and Identification Research Unit (HVIRU), School of Anatomical Sciences, Faculty of Health Sciences, 37708University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Maryna Steyn
- Human Variation and Identification Research Unit (HVIRU), School of Anatomical Sciences, Faculty of Health Sciences, 37708University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
| | - Desiré Brits
- Human Variation and Identification Research Unit (HVIRU), School of Anatomical Sciences, Faculty of Health Sciences, 37708University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa
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Brooks T, Zwirner J, Hammer N, Ondruschka B, Jermy M. Preliminary observations of the sequence of damage in excised human juvenile cranial bone at speeds equivalent to falls from 1.6 m. Int J Legal Med 2020; 135:527-538. [PMID: 32865692 DOI: 10.1007/s00414-020-02409-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/21/2020] [Indexed: 11/29/2022]
Abstract
There is much debate within the forensic community around the indications that suggest a head injury sustained by a child resulted from abusive head trauma, rather than from accidental causes, especially when a fall from low height is the explanation given by a caregiver. To better understand this problem, finite element models of the paediatric head have been and continue to be developed. These models require material models that fit the behaviour of paediatric head tissues under dynamic loading conditions. Currently, the highest loading rate for which skull data exists is 2.81 ms-1. This study improves on this by providing preliminary experimental data for a loading rate of 5.65 ± 0.14 ms-1, equivalent to a fall of 1.6 m. Eleven specimens of paediatric cranial bone (frontal, occipital, parietal and temporal) from seven donors (age range 3 weeks to 18 years) were tested in three-point bending with an impactor of radius 2 mm. It was found that prompt brittle fracture with virtually no bending occurs in all specimens but those aged 3 weeks old, where bending preceded brittle fracture. The maximum impact force increased with age (or thickness) and was higher in occipital bone. Energy absorbed to failure followed a similar trend, with values 0.11 and 0.35 mJ/mm3 for age 3 weeks, agreeing with previously published static tests, increasing with age up to 9 mJ/mm3 for 18-year-old occipital bone. The preliminary data provided here can help analysts improve paediatric head finite element models that can be used to provide better predictions of the nature of head injuries from both a biomechanical and forensic point of view.
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Affiliation(s)
- Tom Brooks
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Johann Zwirner
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Niels Hammer
- Department of Macroscopic and Clinical Anatomy, Medical University of Graz, Graz, Austria.,Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany.,Fraunhofer IWU, Dresden, Germany
| | - Benjamin Ondruschka
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mark Jermy
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand.
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Dempsey N, Blau S. Evaluating the evidentiary value of the analysis of skeletal trauma in forensic research: A review of research and practice. Forensic Sci Int 2020; 307:110140. [PMID: 31958760 DOI: 10.1016/j.forsciint.2020.110140] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/05/2019] [Accepted: 12/29/2019] [Indexed: 12/26/2022]
Abstract
Understanding bone trauma characteristics is a fundamental component of forensic investigations that can assist in understanding the nature of blunt trauma related deaths. The variation of each blunt force trauma (BFT) injury is dependent on a magnitude of factors including, age, sex, health, angle of impact, impact mechanism, impact force and clothing, making BFT one of the more difficult area of trauma to interpret solely based on skeletal fractures. A detailed literature review was performed to assess the value and scientific rigour of the current research in forensic anthropology, forensic pathology and biomechanics that attempts to provide an objective framework in which forensic practitioners can assess and interpret BFT injuries. Four areas of research which investigate the analysis of BFT are examined. These included research involving experiments on animal models; experiments on human models (and synthetic models); computer modelling, and research/publications including 'mild', 'moderate' and 'severe' as descriptions of impact force, resulting from trauma. Also briefly discussed is how BFT research is framed within medicolegal contexts. While many published works have contributed to the understanding of the biomechanics of BFT, more research that can provide an objective means to accurately assess and interpret BFT injures is required.
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Affiliation(s)
- Nicholas Dempsey
- Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia.
| | - Soren Blau
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia.
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7
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Isa MI, Fenton TW, Goots AC, Watson EO, Vaughan PE, Wei F. Experimental investigation of cranial fracture initiation in blunt human head impacts. Forensic Sci Int 2019; 300:51-62. [DOI: 10.1016/j.forsciint.2019.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/31/2019] [Accepted: 04/03/2019] [Indexed: 11/28/2022]
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Undetected traumatic diastasis of cranial sutures: a case of child abuse. Forensic Sci Int 2019; 298:307-311. [PMID: 30925349 DOI: 10.1016/j.forsciint.2019.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/16/2018] [Accepted: 03/07/2019] [Indexed: 11/22/2022]
Abstract
Traumatic diastasis of cranial sutures is a type of bone fracture more common in children than in adults, but little attention has been paid to this skull damage. Differentiation between inflicted and accidental traumatic head injury is still a challenge in forensic pathology, particularly in pediatric population. In fact, diastasis of cranial sutures may occur with or without other skull fractures and may be the only evidence of an abusive head trauma (AHT). This is a case study dealing with undetected traumatic diastasis of cranial sutures in child abuse. The skeletonized juvenile remains were found inside a suitcase. A diastasis of the coronal and sagittal sutures was the only finding recorded at the autopsy with no other relevant bone defects. The diastasis was originally attributed by the medical examiner to a physiological unfused stage of the calvarial bones. Therefore, the cause of death was undetermined. Twelve years later an anthropological revision of the cold case showed that diastasis of the coronal and sagittal sutures was assessed as the evidence of an AHT. Analysis of skull fractures in child abuse can be challenging as normal skull suture variants mimicking intentional injury are reported. Diastasis of the cranial sutures can be also a post-mortem effect of burning or freezing. Therefore, a differential diagnosis between natural, accidental or inflicted skull defects is mandatory in death investigation. A multidisciplinary approach in such circumstances is strongly recommended in order to reduce the risk of misdiagnosis.
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Li X, Sandler H, Kleiven S. Infant skull fractures: Accident or abuse? Forensic Sci Int 2019; 294:173-182. [DOI: 10.1016/j.forsciint.2018.11.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 10/18/2018] [Accepted: 11/08/2018] [Indexed: 11/28/2022]
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10
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Li X, Sandler H, Kleiven S. The importance of nonlinear tissue modelling in finite element simulations of infant head impacts. Biomech Model Mechanobiol 2017; 16:823-840. [PMID: 27873038 PMCID: PMC5422506 DOI: 10.1007/s10237-016-0855-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 11/11/2016] [Indexed: 11/14/2022]
Abstract
Despite recent efforts on the development of finite element (FE) head models of infants, a model capable of capturing head responses under various impact scenarios has not been reported. This is hypothesized partially attributed to the use of simplified linear elastic models for soft tissues of suture, scalp and dura. Orthotropic elastic constants are yet to be determined to incorporate the direction-specific material properties of infant cranial bone due to grain fibres radiating from the ossification centres. We report here on our efforts in advancing the above-mentioned aspects in material modelling in infant head and further incorporate them into subject-specific FE head models of a newborn, 5- and 9-month-old infant. Each model is subjected to five impact tests (forehead, occiput, vertex, right and left parietal impacts) and two compression tests. The predicted global head impact responses of the acceleration-time impact curves and the force-deflection compression curves for different age groups agree well with the experimental data reported in the literature. In particular, the newly developed Ogden hyperelastic model for suture, together with the nonlinear modelling of scalp and dura mater, enables the models to achieve more realistic impact performance compared with linear elastic models. The proposed approach for obtaining age-dependent skull bone orthotropic material constants counts both an increase in stiffness and decrease in anisotropy in the skull bone-two essential biological growth parameters during early infancy. The profound deformation of infant head causes a large stretch at the interfaces between the skull bones and the suture, suggesting that infant skull fractures are likely to initiate from the interfaces; the impact angle has a profound influence on global head impact responses and the skull injury metrics for certain impact locations, especially true for a parietal impact.
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Affiliation(s)
- Xiaogai Li
- Division of Neuronic Engineering, School of Technology and Health, Royal Institute of Technology-KTH, 141 52, Huddinge, Sweden.
| | - Håkan Sandler
- Department of Surgical Sciences/Forensic Medicine, Uppsala University, Uppsala, Sweden
- National Board of Forensic Medicine, Uppsala, Sweden
| | - Svein Kleiven
- Division of Neuronic Engineering, School of Technology and Health, Royal Institute of Technology-KTH, 141 52, Huddinge, Sweden
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Macoveciuc I, Márquez-Grant N, Horsfall I, Zioupos P. Sharp and blunt force trauma concealment by thermal alteration in homicides: An in-vitro experiment for methodology and protocol development in forensic anthropological analysis of burnt bones. Forensic Sci Int 2017; 275:260-271. [DOI: 10.1016/j.forsciint.2017.03.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 01/16/2017] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
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12
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The effect of impact tool geometry and soft material covering on long bone fracture patterns in children. Int J Legal Med 2017; 131:1011-1021. [DOI: 10.1007/s00414-017-1532-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
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13
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Haut RC, Wei F. Biomechanical Studies on Patterns of Cranial Bone Fracture Using the Immature Porcine Model. J Biomech Eng 2017; 139:2545811. [DOI: 10.1115/1.4034430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Indexed: 11/08/2022]
Abstract
This review was prepared for the American Society of Mechanical Engineers Lissner Medal. It specifically discusses research performed in the Orthopaedic Biomechanics Laboratories on pediatric cranial bone mechanics and patterns of fracture in collaboration with the Forensic Anthropology Laboratory at Michigan State University. Cranial fractures are often an important element seen by forensic anthropologists during the investigation of pediatric trauma cases litigated in courts. While forensic anthropologists and forensic biomechanists are often called on to testify in these cases, there is little basic science developed in support of their testimony. The following is a review of studies conducted in the above laboratories and supported by the National Institute of Justice to begin an understanding of the mechanics and patterns of pediatric cranial bone fracture. With the lack of human pediatric specimens, the studies utilize an immature porcine model. Because much case evidence involves cranial bone fracture, the studies described below focus on determining input loading based on the resultant bone fracture pattern. The studies involve impact to the parietal bone, the most often fractured cranial bone, and begin with experiments on entrapped heads, progressing to those involving free-falling heads. The studies involve head drops onto different types and shapes of interfaces with variations of impact energy. The studies show linear fractures initiating from sutural boundaries, away from the impact site, for flat surface impacts, in contrast to depressed fractures for more focal impacts. The results have been incorporated into a “Fracture Printing Interface (FPI),” using machine learning and pattern recognition algorithms. The interface has been used to help interpret mechanisms of injury in pediatric death cases collected from medical examiner offices. The ultimate aim of this program of study is to develop a “Human Fracture Printing Interface” that can be used by forensic investigators in determining mechanisms of pediatric cranial bone fracture.
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Affiliation(s)
- Roger C. Haut
- Orthopaedic Biomechanics Laboratories, Department of Radiology, College of Osteopathic Medicine
- Department of Mechanical Engineering, College of Engineering, Michigan State University, A407 East Fee Hall, East Lansing, MI 48824 e-mail:
| | - Feng Wei
- Orthopaedic Biomechanics Laboratories, Department of Radiology, College of Osteopathic Medicine
- Department of Mechanical Engineering, College of Engineering, Michigan State University, A-414B East Fee Hall, East Lansing, MI 48824 e-mail:
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Wei F, Bucak SS, Vollner JM, Fenton TW, Jain AK, Haut RC. Classification of Porcine Cranial Fracture Patterns Using a Fracture Printing Interface,,. J Forensic Sci 2016; 62:30-38. [DOI: 10.1111/1556-4029.13231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 03/17/2016] [Accepted: 04/02/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Feng Wei
- Orthopaedic Biomechanics Laboratories; Michigan State University; East Lansing MI 48824
- Department of Radiology; Michigan State University; East Lansing MI 48824
- Department of Mechanical Engineering; Michigan State University; East Lansing MI 48824
| | - Serhat Selçuk Bucak
- Department of Computer Science and Engineering; Michigan State University; East Lansing MI 48824
| | - Jennifer M. Vollner
- Department of Anthropology; Michigan State University; East Lansing MI 48824
| | - Todd W. Fenton
- Department of Anthropology; Michigan State University; East Lansing MI 48824
| | - Anil K. Jain
- Department of Computer Science and Engineering; Michigan State University; East Lansing MI 48824
| | - Roger C. Haut
- Orthopaedic Biomechanics Laboratories; Michigan State University; East Lansing MI 48824
- Department of Radiology; Michigan State University; East Lansing MI 48824
- Department of Mechanical Engineering; Michigan State University; East Lansing MI 48824
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15
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Hale AR, Ross AH. The Impact of Freezing on Bone Mineral Density: Implications for Forensic Research. J Forensic Sci 2016; 62:399-404. [DOI: 10.1111/1556-4029.13273] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 05/11/2016] [Accepted: 05/28/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Amanda R. Hale
- Department of Biological Sciences; NCSU; 127 David Clark Labs, Campus Box 7617 Raleigh NC 27695-7617
| | - Ann H. Ross
- Department of Biological Sciences; NCSU; 127 David Clark Labs, Campus Box 7617 Raleigh NC 27695-7617
- Forensic Sciences Institute; NCSU; Raleigh NC 27695
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Jiang B, Zhu F, Cao L, Presley BR, Shen M, Yang KH. Computational Study of Fracture Characteristics in Infant Skulls Using a Simplified Finite Element Model. J Forensic Sci 2016; 62:39-49. [DOI: 10.1111/1556-4029.13241] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 01/10/2016] [Accepted: 03/19/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Binhui Jiang
- The State Key Laboratory of Advanced Design and Manufacturing for Vehicle Body; Hunan University; Hunan 410082 China
- Bioengineering Center; Wayne State University; MI 48201 China
| | - Feng Zhu
- The State Key Laboratory of Advanced Design and Manufacturing for Vehicle Body; Hunan University; Hunan 410082 China
- Bioengineering Center; Wayne State University; MI 48201 China
| | - Libo Cao
- The State Key Laboratory of Advanced Design and Manufacturing for Vehicle Body; Hunan University; Hunan 410082 China
| | | | - Ming Shen
- Bioengineering Center; Wayne State University; MI 48201 China
| | - King H. Yang
- Bioengineering Center; Wayne State University; MI 48201 China
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17
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Love JC, Wiersema JM. Skeletal Trauma: An Anthropological Review. Acad Forensic Pathol 2016; 6:463-477. [PMID: 31239921 PMCID: PMC6474561 DOI: 10.23907/2016.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/24/2016] [Accepted: 08/03/2016] [Indexed: 11/12/2022]
Abstract
As anthropologists take on a larger role in medical examiner's offices, the incorporation of bone trauma analysis into the autopsy increases. The purpose of this invited review is to summarize recent anthropological literature that exemplifies the value of forensic anthropology in medicolegal death investigation, concentrating in the area of skeletal trauma analysis. Forensic anthropologists have a strong understanding of bone's response to trauma, gained through research and case studies. With this body of knowledge they are able to examine and interpret skeletal injury resulting from blunt, sharp, firearm, and thermal trauma. For example, toolmark class characteristics are recognized through sharp force injury examination, and fracture pattern analysis provides details of the impacting surface area. Interpretation of skeletal trauma allows for reconstruction of events surrounding death, and may inform the manner of death classification.
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Affiliation(s)
- Jennifer C. Love
- District of Columbia Office of the Chief Medical Examiner -
Anthropology
| | - Jason M. Wiersema
- Harris County Institute of Forensic Sciences - Forensic
Anthropology Division
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18
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Love JC. The Value of Anthropology in Medicolegal Death Investigation of Pediatric Nonaccidental Injury. Acad Forensic Pathol 2016; 6:478-485. [PMID: 31239922 DOI: 10.23907/2016.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/21/2016] [Accepted: 08/25/2016] [Indexed: 11/12/2022]
Abstract
Forensic anthropologists have made remarkable contributions to the medicolegal investigation of nonaccidental injury in pediatric cases. They have created standard nomenclature for fracture descriptions. Anthropologists have developed novel techniques that increase the sensitivity of the pediatric autopsy. They have performed biomechanical research that enables reconstruction of events surrounding death. Also, anthropology practitioners have developed several reference guides on the subject of nonaccidental injury that are of value to forensic pathologists. These advancements assist forensic pathologists in the accurate classification of cause and manner of death in pediatric cases.
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Affiliation(s)
- Jennifer C Love
- District of Columbia Office of the Chief Medical Examiner - Anthropology
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19
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Vaughan PE, Vogelsberg CCM, Vollner JM, Fenton TW, Haut RC. The Role of Interface Shape on the Impact Characteristics and Cranial Fracture Patterns Using the Immature Porcine Head Model,. J Forensic Sci 2016; 61:1190-7. [PMID: 27135279 DOI: 10.1111/1556-4029.13111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 10/27/2015] [Accepted: 11/02/2015] [Indexed: 11/29/2022]
Abstract
The forensic literature suggests that when adolescents fall onto edged and pointed surfaces, depressed fractures can occur at low energy levels. This study documents impact biomechanics and fracture characteristics of infant porcine skulls dropped onto flat, curved, edged, and focal surfaces. Results showed that the energy needed for fracture initiation was nearly four times higher against a flat surface than against the other surfaces. While characteristic measures of fracture such as number and length of fractures did not vary with impact surface shape, the fracture patterns did depend on impact surface shape. While experimental impacts against the flat surface produced linear fractures initiating at sutural boundaries peripheral to the point of impact (POI), more focal impacts produced depressed fractures initiating at the POI. The study supported case-based forensic literature suggesting cranial fracture patterns depend on impact surface shape and that fracture initiation energy is lower for more focal impacts.
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Affiliation(s)
- Patrick E Vaughan
- Orthopaedic Biomechanics Laboratories, Michigan State University, East Lansing, MI, 48824
| | | | - Jennifer M Vollner
- Department of Anthropology, Michigan State University, East Lansing, MI, 48824
| | - Todd W Fenton
- Department of Anthropology, Michigan State University, East Lansing, MI, 48824
| | - Roger C Haut
- Orthopaedic Biomechanics Laboratories, Michigan State University, East Lansing, MI, 48824.
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20
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Deland TS, Niespodziewanski E, Fenton TW, Haut RC. The Role of Interface on the Impact Characteristics and Cranial Fracture Patterns Using the Immature Porcine Head Model. J Forensic Sci 2015; 61 Suppl 1:S53-9. [DOI: 10.1111/1556-4029.12939] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 01/27/2015] [Accepted: 02/12/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Trevor S. Deland
- Orthopaedic Biomechanics Laboratories; Michigan State University; East Lansing MI
| | | | - Todd W. Fenton
- Department of Anthropology; Michigan State University; East Lansing MI
| | - Roger C. Haut
- Orthopaedic Biomechanics Laboratories; Michigan State University; East Lansing MI
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21
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How hard is hard enough? An investigation of the force associated with lateral blunt force trauma to the porcine cranium. Leg Med (Tokyo) 2015; 17:1-8. [DOI: 10.1016/j.legalmed.2014.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/21/2014] [Accepted: 07/28/2014] [Indexed: 11/23/2022]
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22
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Powell BJ, Passalacqua NV, Fenton TW, Haut RC. Fracture Characteristics of Entrapped Head Impacts Versus Controlled Head Drops in Infant Porcine Specimens,,. J Forensic Sci 2013; 58:678-83. [DOI: 10.1111/1556-4029.12094] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 01/16/2012] [Accepted: 03/25/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Brian J. Powell
- Orthopaedic Biomechanics Laboratories; College of Osteopathic Medicine, Michigan State University; East Lansing; MI; 48824
| | - Nicholas V. Passalacqua
- Department of Anthropology; College of Social Sciences, Michigan State University; East Lansing; MI; 48824
| | - Todd W. Fenton
- Department of Anthropology; College of Social Sciences, Michigan State University; East Lansing; MI; 48824
| | - Roger C. Haut
- Orthopaedic Biomechanics Laboratories; College of Osteopathic Medicine, Michigan State University; East Lansing; MI; 48824
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23
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Jordana F, Colat-Parros J, Bénézech M. Diagnosis of Skull Fractures According to Postmortem Interval: An Experimental Approach in a Porcine Model. J Forensic Sci 2012; 58 Suppl 1:S156-62. [DOI: 10.1111/1556-4029.12012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Revised: 12/27/2011] [Accepted: 12/31/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Fabienne Jordana
- Robert Picqué Armed Forces Teaching Hospital; 351 Route de Toulouse, CS 80002; 33882; Villenave d'Ornon Cedex; France
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24
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Powell BJ, Passalacqua NV, Baumer TG, Fenton TW, Haut RC. Fracture Patterns on the Infant Porcine Skull Following Severe Blunt Impact*. J Forensic Sci 2011; 57:312-7. [DOI: 10.1111/j.1556-4029.2011.01969.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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