Trauma Analysis 25/02/2008 13:46:00

Trauma: any force caused to an individual by an external force

Mechanical Trauma

• Blunt force

o Something coming at low velocity impacting over a fairly large

area

o Projectiles

 Guns, bullets, arrows,

o Sharp force trauma

 Force is acting over very small area, think knife

Fracture Mechanics

• Stress: force applied

• Strain: Deformation of an object due to that stress

o Change in shape.

• Failure: Fracture. Once the bone has gone past the point of going
back to normal

Deformation

• Elastic

o Reversible. The amount of force applied is not going to affect

the bone permanent.

• Plastic

o The bone is never going to go back to its original shape.

Irreversible.

• Failure
 o When the stress and strain is too high, it will fail. The bone will
never go back to the original shape, or even the plastic shape.

Forces causing Trauma

• Direction of the force, where it is going to contact the bone, the

speed, and how focused it is.

• Tension

o Bone is being pulled on. It is being lengthened. Usually a

factor on the joint more than the actual bone.

• Compression

o The bone is being compressed on its long side.

• Bending

o Most common. Bone compression and tension acting on a

bone. The side of the bone it is being pushed on. Bone is most
likely to fail on the side of tension

• Shear

o Kind of a sliding force. On end of the bone is immobilized then

force comes at a right angle of the bone.

• Torsion (twist)

o One end of the bone is stable and the other side is twisting.

Fracture types

• Greenstick

o A fracture that does not go all the way through the bone. Most
often found on juveniles

• Oblique

o Sprital/torsion

• Comminuted
 o Most commonly found on things like car accidents. A lot of
little small pieces.

• Transverse

o Plain old horizontal line fracture

• Compound

o Breaking the skin

• Compression

o Most commonly found on the vertebrae.

Stages of Fracture Repair

• 1. Hematoma

o blood vessels have also burst.

• 2. Cellular

o osteoclasts & osteoblasts

Timing of Trauma

• Physical properties of bone

o Two face composite with an organic and inorganic

components

o Collagen

 Makes it kind of rubbery

o Calcium hydroxyapatite

 Mineral component. It gives it strength

• Antemortem
 o If there is any evidence of the bone healing it is considered
before death. It takes about a week before any healing starts
showing.

• Perimortem

o Around the time of death. You will not see any healing. You
might see some staining.

• Postmortem

o It will look like it was snapped. Sharp breaks. Long bones will
usually break at right angles. No types of fracture lines.

Common Fractures

• Boxer’s fracture: 5th metacarpal

• Colles’ Fracture: distal radius

• Parry Fracture: distal ulna

• Pars fracture: 5th lumbar vertebrae

What happens if fractures don’t heal correctly?

• Heals at an angle

o Can affect mobility, muscles, etc

• Pseudoarthrosis

o False joints. The bones never unite and there is a space

between them.

Blunt Force Trauma

• A force not moving super fast, over a larger area.

Analyzing BFT

• Implement. Very hard to know the instrument that was used for
BFT.
 • Fracture sequence

o Impact on the surface, it causes compression, the opposite

side of the bone has tension. Fractures will penetrate through
that bone.

• Plastic deformation

o Slow loading of the force.

Cranial fracture from BFT

• Impact on the outer table. That will cause compression. Force

travels through the other side and cause tension.

• Two types of fractures in the skull

o Radiating fracture

 Radiate out from that center of force

o Concentric fracture

 Circular that happens after the radiating fracture

Number & Sequence of blows

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