Forensic medical characteristics of bone fractures of the hand

Abstract

BACKGROUND: The forensic medical aspects of closed bone fractures of the hands are important in connection with the need to establish the nature, mechanism of occurrence, severity, and duration of these injuries. AIM: This study aimed to assess the severity of closed bone fractures of the hands based on the features of the formation, course, and outcomes. MATERIAL AND METHODS: Fractures of wrist bones (n = 24) and metacarpal bones (n = 218) were examined in persons struck by blunt objects. RESULTS: Scaphoid bone fractures (81.8%) most often occurred on the side of the carpals, and fractures of other carpal bones are detected relatively less frequently (18.2%). With closed fractures of the navicular bone, especially in cases of late seeking medical help, complications such as a false joint and aseptic necrosis can be observed, causing pronounced radiocarpal joint dysfunction. In the metacarpal bones, periarticular fractures of the proximal epiphysis (49.1%) are often noted, followed by intra-articular fractures (26.6%) and periarticular diaphyseal fractures (20.6%). Complications such as finger contractures in chronic metacarpal bone fractures were most observed in intra-articular, comminuted with mixed, and transverse fractures. CONCLUSION: Isolated uncomplicated closed fractures of wrist bones have moderate severity. Moreover, scaphoid bone fractures, complicated by a false joint and aseptic necrosis, causing severe wrist joint dysfunction, and ultimately joint immobility in a functionally disadvantageous position, according to the criterion of total disability, qualify as severe injury. The severity of the harm caused to the health of complicated and uncomplicated isolated metacarpal fractures can be classified as moderate.