India - December 14, 2024

Fracture Analysis in Autopsy

December 14, 2024

0 7 min read

Need for Autopsy in every death –

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Study of Fracture in ascertaining cause of death:

Fractures which are breaking of bones, usually happens when too much force is applied to a bone, usually during a fall from height or a Road Traffic accident. Fracture of a bone is defined as a breach in

the continuity of a bone or a complete or incomplete discontinuity of bone caused by direct or indirect injury. Over 1,66,000 people have died in India in road traffic accidents in 2023 alone; which is more than the number of soldiers killed in all the wars that we have fought till date. But fractures may also occur due to several domestic falls, due to a gunshot injury, a blunt attack with some heavy object.

Majority of fractures occur in children or in elderly people, since young and middle-aged adults generally have very strong bones, unless having an orthopaedical degenerative disorder.

An autopsy surgeon encounters different types of mechanical injuries during examination like abrasion, laceration, contusion etc. Fracture of bone is a common form of mechanical injury which may sometimes be the only cause or a contributory factor in the cause of death. Usually, fractures occur accidentally, though they may also be present in suicidal or homicidal deaths. They have omnipotent importance medicolegally, for the manner of the cause of fracture, the type of weapon used, the gravity of the trauma, the direction of infliction, etc.

A cross-sectional autopsy-based study, in association with the clinical records available, so conducted has revealed the following statistics:

Fractures due to Road Traffic Accidents was 80% in males, as compared to 20% in females. But the percentage of fractures due to fall was almost the same in both the genders – 51% in males, and 49% in females respectively.

Fractures due to both the causes of domestic fall and Road Traffic Accident were more prevalent in the age group 25 to 55 years. Most noticeably when most of the deaths occurred within the first 6 hours of the incident, very few victims could manage to survive more than a month.

While ascertaining the percentile of deaths arising of fracture, it was demonstrated that the majority of fractures around 50% were due to Road Traffic Accident; 30% were due to domestic falls; 12% were due to suicidal & homicidal hanging; and, 8% due to blunt injuries. Among the domestic fall category, 18% were fall from height, and 12% reportedly felled inside the bathroom.

Higher number of deaths occurred during June to September when rainfall was abundant.

Most of the incumbents had died, arising due to fracture in the axial skeleton – skull (40%), vertebra (16%) and Thoracic fracture (20%). Remaining (24%) had multiple fractures, causing death.

The maximum number of road traffic accident-related fatalities were observed to have been recorded during 20.00 hours to Midnight (00.00 hours), and the second highest numbers are during 12.00 hours to 16.00 hours, while the least number were recorded between Midnight (00.00 hours) to 04.00 hours. In this study, majority of Road Traffic Accidents took place

between 06.00 hours to 12.00 hours, but fractures due to domestic fall were frequent from 12.00 hours to 18.00 hours.

Aftermath a Road Traffic Accident, 35% of the victims survived less than 6 hours; while in the case of a fall from height it was around 40% who had survived less than 6 hours. Again, 10% of the victims of RTA had survived for more than a month; while almost 20% of the victims had survived for more than a month after a fall.

It is mention-worthy that the first six hours, is the most crucial period, following the development of fracture, which needs proper medical attention to avoid death.

To be continued…………..