FORENSIC MEDICAL DETERMINATION OF THE SEVERITY OF CHEST INJURIES WITH RIB CAGE TRAUMA
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Keywords

forensic examination, chest injury, diagnostic criteria, severity of injuries

Abstract

Background. Closed chest trauma with rib fractures is a common injury to the external respiratory system. Victims with such an injury may be subject to forensic examination.

Purpose. The aim of the study was to determine the severity of injuries in patients with closed chest trauma with violation of the integrity of the costal skeleton, treated in a specialized surgical hospital, to establish additional criteria for forensic diagnosis of such trauma.

Subjects and Methods. 71 medical cards of inpatients, patients with chest injuries who were treated at the Kharkiv Institute of General and Emergency Surgery named after V.T. Zaitseva. A forensic medical evaluation of closed chest injuries with rib fractures was performed according to the severity of injuries according to clinical observations. Morphological and clinical approach was used to determine the severity of injuries.

Results. Severe injuries were found in 14 (19.7%) cases of injuries, mainly with the occurrence of a life-threatening phenomenon, namely acute respiratory failure. Moderate injuries were found in 57 (80.3%) cases of chest injuries with rib fractures in the absence of danger to life.

Conclusions. It is established that in the available scientific and methodological literature there are no diagnostic morpho-clinical signs for qualitative forensic assessment and prediction of the final results of closed chest injuries, there are different views on forensic assessment. It is determined that when applying the morphological and clinical approach of forensic assessment, additional diagnostic criteria for closed chest injuries, should be considered when determining the severity of injuries: dynamics and duration of recovery of post-traumatic morphological and functional changes of injured organs. or the entire respiratory system (lungs), the occurrence of life-threatening phenomena. The ways of further improvement of forensic diagnostics in the assessment of these injuries by the degree of their severity are identified.

https://doi.org/10.35339/ic.9.1.45-49
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References

Styazhkina SN, Distanova AA, Hadeev YaR. Klinicheskij sluchaj zakrytoj travmy grudnoj kletki posle dorozhno-transportnogo proisshestviya [Clinical case of closed chest injury after a traffic accident]. Modern Science. 2020;3(1):316‒9. [In Russian].

Karmy-Jones R, Wood DE. Traumatic injury to the trachea and bronchus. Thorac Surg Clin. 2007;17:35–46.

Gasymzade GSH. Comparative characteristics of computed tomography and radiography in the diagnosis of blunt chest trauma. KMZh. 2020;6(101):926-9. [in Russian].

Balci AE, Balci TA, Eren S, Ulkü R, Cakir O, Eren N. Unilateral posttraumatic pulmonary contusion: find-ings of a review. Surg. Today. 2005;35(3):205‒10.

Kovalev BV, Dzhuvalyakov PG, Tat'yanchenko VK, Krasenkov YuV, Suhaya YuV. Peculiarities of pathogen-esis in chest trauma. AMZh. 2016;1(4):136-143. [in Russian].

Tetenev FF, Bodrova TN, Tetenev KF, Karzilov AI, Levchenko AV, Kalinina OV. The study of the function of the apparatus of external respiration. Fundamentals of Clinical Physiology of Respiration: Textbook. 2nd ed., add. and correct. T.: " Sand manufactory"; 2008. 164 p. [In Russian].

Madani A, Pecorelli N, Razek T, Spicer J, Ferri LE, Mulder DS. Civilian airway trauma: a single-institution experience. World J Surg. 2016;40:2658–66.

Payne-James J, Richard Martin J. Simpson's Forensic Medicine R.M., 14th Edition 14th Edition. USA, Boca Raton: CRC Press; 2019. 353 p.

Pillay VV. Textbook of Forensic Medicine and Toxicology. 19th Edition. India: Paras Medical Publisher; 2019. 800 p.

Kupryushin AS, Efimov AA, Loginov SN, Vishnyakova ZHS, Latynova IV, Semina MN, et al. Clinical mani-festations and forensic evaluation of hemothorax]. SNMZh. 2017;13(2):221–4. [In Russian].

Pravyla sudovo-medychnoho vyznachennia stupenia tiazhkosti tilesnykh ushkodzhen [Rules for forensic medical assessment of bodily injuries severity]. In: Order of the Ministry of Health of Ukraine, No.6 on 17 Jan 1995. "Pro rozvytok ta vdoskonalennia sudovo-medychnoi sluzhby Ukrainy". ["On the development and improvement of the foren-sic medical service of Ukraine"]. [In Ukrainian].

Naida AI, Malyk OR. Sudova medytsyna: kompleksnyi navch. posib. [Forensic medicine: a comprehensive textbook]. K.: Atika; 2012. 272 p. [in Ukrainian].

Klevno VA, Maksimov AV. Kliniko-morfologicheskij analiz oshibochnoj diagnostiki travmy grudnoj kletki i zhivota [Clinical and morphological analysis of erroneous diagnosis of trauma to the chest and abdomen]. VMV. 2019;3(63): 31‒6.

Klevno VA. Bogomolova IN. Opredelenie stepeni tyazhesti vreda zdorov'yu. Primenenie pravil i medicinskih kriteriev. Otvety na voprosy [Determining the severity of harm to health. Application of rules and medical criteria. An-swers on questions]. M.: GEOTAR-Media; 2010. 136 p. [In Russian].

Le Guen M, Beigelman C, Bouhemad B, Wenjïe Y, Marmion F, Rouby JJ. Chest computed tomography with multiplanar reformatted images for diagnosing traumatic bronchial rupture: a case report. Crit Care. 2007;11(5):R94. DOI: 10.1186/cc6109. PMID: 17767714.

Newbury A, Dorfman JD, Lo HS. Imaging and management of thoracic trauma. Semin Ultrasound CT MR. 2018;39(4):347‒54.

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