[关节损伤的法医学特征]。

A I Iskandarov, S I Indiaminov, I G Zhurayev
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引用次数: 0

摘要

本研究的目的是:完善关节损伤主要关节损伤的形成机制和关节损伤对健康危害程度的评定标准。接受检查的患者人数为246人,他们在不同的情况下遭受痛苦。在行人和骑自行车的人与行驶中的车辆发生碰撞的非致命性损伤中,关节区域的皮肤和软组织损伤(47%)、关节内骨折(18.0%)和关节周围骨折(15.8%)最为常见,而不受内部结构的影响。在道路交通事故(RTA)中,从关节结构侧面受伤的行人和骑自行车的人最常见的是关节周围骨折(6.8%)、关节内骨折伴关节面一致性受损(14.5%)或完整(6.5%)。机械损伤中常见脱位(45.9%)和脱位骨折(54.1%)。大多数情况下,在关节周围骨折的情况下,工作能力恢复了1.5-2.0个月,没有永久性的一般工作能力丧失。在复杂的髋关节内结构骨折的情况下,一般工作能力的永久丧失超过33.0%,而在其他关节的类似损伤的情况下低于该值。关节内骨折的工作能力恢复期为2.5-3个月,复杂脱位的工作能力康复期为3-6个月。一般工作能力的永久丧失不超过30%。骨折脱位患者的工作能力恢复期为3-6个月。在这种情况下,一般工作能力的永久性损失从20%到60%。在关节结构的无复杂孤立损伤的情况下,健康危害的严重程度被归类为中度,在存在复杂孤立损伤时,健康危害严重程度被分类为中度或重度。关节软组织损伤被评估为轻度身体损伤,导致健康障碍。在RTA的情况下,行人和骑自行车的人在摔倒在路面上时会形成关节软组织损伤,以及关节周围和关节内骨折。肱骨和前臂的脱位和骨折脱位是间接损伤机制的结果。股骨关节损伤是在股骨受到外力的影响下形成的,超过了髋关节的能力(一种间接损伤机制)。踝关节脱位和骨折脱位是一种间接损伤机制的结果,是由脚的屈曲或大力旋转引起的。
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[Forensic medical characteristic of articular injuries].

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.

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来源期刊
Sudebno-Meditsinskaya Ekspertisa
Sudebno-Meditsinskaya Ekspertisa Medicine-Pathology and Forensic Medicine
CiteScore
0.60
自引率
0.00%
发文量
70
期刊介绍: The journal is concerned with the theory and practice of forensic medicine - the problems of thanatology, traumatology, toxicology, serology, forensic obstetrics, forensic dentistry, forensic psychiatry, forensic chemistry, physicotechnical methods of investigation, history of forensic medicine and some problems of criminology and legal laws related to forensic medicine. It publishes original studies by Russian authors, casuistry surveys, abstracts and reviews of Russian and foreign literature, scientific information, reports on scientific conferences.
期刊最新文献
[Comparative analysis of factors influencing suicidal actions performance before and during the COVID-19 pandemic]. [Correlation between defects in medical care and data of causal analysis]. [Determination of 2,4-dimethylhydroxybenzene by chromatographic methods in forensic toxicological research of biological material]. [Development of a carbamazepine determination method based on high-performance liquid chromatography with diode array]. [Development of selective method for mebeverine detection in blood].
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