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Infant skull fractures: Accident or abuse?: Evidences from biomechanical analysis using finite element head models
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Neuronic Engineering.
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Neuronic Engineering.ORCID iD: 0000-0003-0125-0784
2019 (English)In: Forensic science international, Vol. 294, p. 173-182Article in journal (Refereed) Published
Abstract [en]

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. 

Place, publisher, year, edition, pages
Elsevier , 2019. Vol. 294, p. 173-182
Keywords [en]
Abusive Head Trauma; Multiple skull fractures; Finite element head model; Ossification centers; Impact location
National Category
Engineering and Technology
Identifiers
URN: urn:nbn:se:kth:diva-259171DOI: 10.1016/j.forsciint.2018.11.008ISI: 000454861200029Scopus ID: 2-s2.0-85057577148OAI: oai:DiVA.org:kth-259171DiVA, id: diva2:1350690
Note

QC 20190923

Available from: 2019-09-12 Created: 2019-09-12 Last updated: 2019-10-09Bibliographically approved

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Li, XiaogaiKleiven, Svein

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