Journal
FORENSIC SCIENCE INTERNATIONAL
Volume 294, Issue -, Pages 173-182Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.forsciint.2018.11.008
Keywords
Abusive Head Trauma; Multiple skull fractures; Finite element head model; Ossification centers; Impact location
Categories
Funding
- Swedish Research Council [2016-04203]
- Swedish National Board of Forensic Medicine [RMV 4155451]
- Swedish Research Council [2016-04203] Funding Source: Swedish Research Council
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Abusive Head Trauma (AHT) is considered by some authors to be a leading cause of traumatic death in children less than two years of age and skull fractures are commonly seen in cases of suspected AHT. Today, diagnosing whether the observed fractures are caused by abuse or accidental fall is still a challenge within both the medical and the legal communities and the central question is a biomechanical question: can the described history explain the observed fractures? Finite element (FE) analysis has been shown a valuable tool for biomechanical analysis accounting for detailed head geometry, advanced material modelling, and case-specific factors (e.g. head impact location, impact surface properties). Here, we reconstructed two well-documented suspected abuse cases (a 3- and a 4-month-old) using subject-specific FE head models. The models incorporate the anatomical details and age-dependent anisotropic material properties of infant cranial bones that reflect the grainy fibres radiating from ossification centres. The impact locations are determined by combining multimodality images. The results show that the skull fracture patterns in both cases of suspected abuse could be explained by the described accidental fall history, demonstrating the inherent potential of FE analysis for providing biomechanical evidence to aid forensic investigations. Increased knowledge of injury mechanisms in children may have enormous medico-legal implications world-wide. (C) 2018 Published by Elsevier B.V.
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