[Fatal injury in childhood. Analysis of 160 autopsies]

During the period from 1971 to 1987 160 deadly injured children were dissected at the Institute of forensic medicine in Hamburg-Eppendorf. 72.5% of the children died after a traffic accident. Injuries of the head as cause of death is the most detected reason. 62% of the children died because of a head injury, 13% in consequence of bleeding and 10.8% because of contusion of the medulla oblongata by injuries of the upper vertebral column. The majority of the children died by injuries of only one cavity (42%). It is conspicuous that the portion of infants (none to three years) is greater than we expected.

[The biomechanical significance of the periosteum for the epiphyseal groove]

In a study of 72 rabbits, four, eight, twelve and 16 weeks old, the mechanical resistance of the distal radius and ulna epiphyseal plate against shear strength has been examined. On one side the extremity has been freed of all soft-tissue attachments except the periosteum, on the other side the periosteum of the epiphyseal plate additional has been removed. The mechanical strength of the epiphyseal cartilage increases with age. A decrease of the resistance during sexual maturation has not been observed. In all age groups the stability of the epi-metaphyseal junction is significantly higher with the periosteum. In younger animals it is more marked than in older ones. The biomechanical behaviour of the periosteum can be explained with the principle of a "traction strap": the fibrous periosteum, firmly attached at the perichondrial ring, is stretched from epiphysis to epiphysis and fixes the epiphysis to the metaphysis. The periosteum and its continous tension takes not only part in regulating the longitudinal growth but also increases the resistance of the growth cartilage against shear strength. The dominated influence of the periosteum on the integrity of the epiphyseal cartilage is also supported by corresponding results dealing with the occurrence of Salter and Harris-type I or II fractures in absence or presence of the periosteum.