Сlosed chest injury with preservation of the integrity of the ribs in the forensic medical assessment of its severity

Abstract

The Aim. the forensic determination of the severity of closed chest injuries with intact ribs in victims hospitalized in a specialized surgical hospital to establish diagnostic expert criteria for expert assessment of such dmages.Materials and methods. 52 case histories of patients hospitalized hospitalized at the Kharkiv institute of general and emergency surgery named after V.T. Zaitseva were analyzed. Patients were divided into 4 groups based on the dynamics of morpho-functional pathological changes of the injured organs, the final results of the injury, and the presence of life-threatening phenomena.Results. The analysis of observations showed that the main traumatic factor in the emergence of the studied cases is the impact mechanism of blunt solid objects on the chest. Patients with closed blunt chest trauma were divided into observation groups depending on the morphology of the injuries received. The following main variants of the received injury are distinguished: without a contusion and bruised chest and the presence of intrapleural injuries and complications, a chest contusion without complications. Severe injuries were estimated in 15.4% of cases of acute respiratory failure and cases of trauma of partial or complete lung loss. Injuries of medium severity were established in 26.9% of cases of trauma in the absence of danger to life. Minor injuries were established in 57.7% of cases of trauma in the presence of intrapleural injuries and complications or minor injuries without any complications.Conclusions. When forensically determining the degree of severity of closed injuries of the chest, it is necessary to evaluate the morphology of the injury and clinic functional manifestations of life-threatening phenomena. At the same time, diagnostic signs which must be used when determining the severity of physical injuries are the following: the presence of clinical and functional signs of acute respiratory failure, loss of part or all of the respiratory organ (lungs), dynamics and duration of recovery of post-traumatic morpho-functional changes injured organs.