Forensic medical determination of severity of chest injuries with thorax trauma

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. 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. Materials and Methods. 71 medical cards of inpatients, patients with chest injuries who were treated at Kharkiv Institute of General and Emergency Surgery named after V.T. Zaitsev were analyzed. 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 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 lifethreatening phenomena. The ways of further improvement of forensic diagnostics in the assessment of these injuries by the degree of their severity are identified.