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Abstract
ABSTRACT We describe 3 infants with skull fractures that involved more than 1 skull bone. On further evaluation, 2 of the 3 infants had additional fractures at other sites of the body and the third infant had concerning bruising of the face. Although an accidental mechanism of injury was initially given as the history in each case, law enforcement investigations led all 3 fathers to confess to crushing their infants' skulls out of frustration. These crushes were caused by their arms or hands. Bilateral skull fractures or those involving more than 1 skull bone can be seen in falls as well as in crush injuries. A crush-like pattern of injury, in the absence of a clear and plausible accidental mechanism, should raise concerns for possible physical abuse especially in nonambulatory infants.
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Affiliation(s)
- Emily C B Brown
- From the Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA
| | | | - Jeffrey P Otjen
- Department of Radiology, Seattle Children's Hospital, University of Washington, Seattle, WA
| | - Kenneth W Feldman
- From the Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA
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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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Muccino E, Porta D, Magli F, Cigada A, Sala R, Gibelli D, Cattaneo C. Applicability of cranial models in urethane resin and foam as a substitute for bone: are synthetic materials reliable? J Forensic Sci 2013; 58:1257-1263. [PMID: 23865474 DOI: 10.1111/1556-4029.12164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 06/28/2012] [Accepted: 06/30/2012] [Indexed: 11/30/2022]
Abstract
As literature is poor in functional synthetic cranial models, in this study, synthetic handmade models of cranial vaults were produced in two different materials (a urethane resin and a self-hardening foam), from multiple bone specimens (eight original cranial vaults: four human and four swine), in order to test their resemblance to bone structure in behavior, during fracture formation. All the vaults were mechanically tested with a 2-kg impact weight and filmed with a high-speed camera. Fracture patterns were homogeneous in all swine vaults and heterogeneous in human vaults, with resin fractures more similar to bone fractures. Mean fracture latency time extrapolated by videos were of 0.75 msec (bone), 1.5 msec (resin), 5.12 msec (foam) for human vaults and of 0.625 msec (bone), 1.87 msec (resin), 3.75 msec (foam) for swine vaults. These data showed that resin models are more similar to bone than foam reproductions, but that synthetic material may behave quite differently from bone as concerns fracture latency times.
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Affiliation(s)
- Enrico Muccino
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute-Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milano, Italy
| | - Davide Porta
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute-Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milano, Italy
| | - Francesca Magli
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute-Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milano, Italy
| | - Alfredo Cigada
- Sezione di Misure e Tecniche Sperimentali, Dipartimento di Meccanica, Politecnico di Milano, Via La Masa 1, 20156, Milano, Italy
| | - Remo Sala
- Sezione di Misure e Tecniche Sperimentali, Dipartimento di Meccanica, Politecnico di Milano, Via La Masa 1, 20156, Milano, Italy
| | - Daniele Gibelli
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute-Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milano, Italy
| | - Cristina Cattaneo
- LABANOF, Laboratorio di Antropologia e Odontologia Forense, Sezione di Medicina Legale, Dipartimento di Scienze Biomediche per la Salute-Sezione di Medicina Legale, Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133, Milano, Italy
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