[Forensic medical characteristic of articular injuries].

Abstract

The aim of the study: Is to refine the mechanism of major joints' damage formation and qualification criteria of harm degree to the health in articular injuries. The number of patients equal 246, suffered in different circumstances, were examined. Damages of skin and soft tissues in the joints region without affection of internal structures (47%), intraarticular fractures with impaired articular surface congruence (18.0%) and periarticular fractures (15.8%) were the most frequent in non-fatal injuries' outcomes in pedestrians and cyclists suffered from collisions with moving vehicles. Dead pedestrians and cyclists injured in road traffic accidents (RTA) from the side of joints structure had the most frequent the periarticular fractures (6.8%), intraarticular fractures with impaired (14.5%) or intact articular surface congruence (6.5%). Dislocations (45.9%) and dislocation-fracture (54.1%) were common in mechanical injuries. Mostly, work ability was recovered for 1.5-2.0 months in the presence of periarticular fracture, and there was no permanent loss of general work ability. The permanent loss of general work ability exceed 33.0% in case of complicated intraarticular fractures of coxofemoral structures, and in the case of a similar injury of other joints was less than this value. The period of work ability recovery in the case of intraarticular fractures was 2.5-3 months, in the presence of complicated dislocations was from 3 to 6 months. The permanent loss of general work ability did not exceed 30%. The period of work ability recovery in patients with fracture-dislocation varied from 3 to 6 months. The permanent loss of general work ability in this case was from 20% to 60%. The severity of harm to the health was classified as moderate degree in the case of uncomplicated isolated injuries of joints structures, and as moderate or severe degree in the presence of complicated isolated injuries. Bruises of joints' soft tissues were evaluated as mild bodily injury causing a health disorder. Bruises of joints' soft tissues, as well as periarticular and intraarticular fractures in pedestrians and cyclists in the case of RTA are formed when falling on the road surface. Dislocations and fractures-dislocations of humerus and forearm occur as a result of an indirect injury mechanism. Articular injuries of femur are formed under the influence of traumatic force to the femur, exceeding the capability of coxofemoral joint (an indirect injury mechanism). Dislocations and fractures-dislocations in ankle joint are occurred as a result of an indirect injury mechanism and are caused by foot's flexion or rotation with great strength.