Background. Closed chest trauma with rib fractures is a common injury to the external respiratory system. Victims with such an injury may be subject to forensic examination. Purpose. The aim of the study was to determine the severity of injuries in patients with closed chest trauma with violation of the integrity of the costal skeleton, treated in a specialized surgical hospital, to establish additional criteria for forensic diagnosis of such trauma. Subjects and Methods. 71 medical cards of inpatients, patients with chest injuries who were treated at the Kharkiv Institute of General and Emergency Surgery named after V.T. Zaitseva. A forensic medical evaluation of closed chest injuries with rib fractures was performed according to the severity of injuries according to clinical observations. Morphological and clinical approach was used to determine the severity of injuries. Results. Severe injuries were found in 14 (19.7%) cases of injuries, mainly with the occurrence of a life-threatening phenomenon, namely acute respiratory failure. Moderate injuries were found in 57 (80.3%) cases of chest injuries with rib fractures in the absence of danger to life. Conclusions. It is established that in the available scientific and methodological literature there are no diagnostic morpho-clinical signs for qualitative forensic assessment and prediction of the final results of closed chest injuries, there are different views on forensic assessment. It is determined that when applying the morphological and clinical approach of forensic assessment, additional diagnostic criteria for closed chest injuries, should be considered when determining the severity of injuries: dynamics and duration of recovery of post-traumatic morphological and functional changes of injured organs. or the entire respiratory system (lungs), the occurrence of life-threatening phenomena. The ways of further improvement of forensic diagnostics in the assessment of these injuries by the degree of their severity are identified.

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Detainees often complain about the unlawful use of force when special means and methods of detention were used, which they take as beatings and torture. Victims with such injuries commonly become the object of forensic medical examination of alive persons which is carried out during the trial and pre-trial investigation. There is a need to systematize and classify many types of mechanical and other types of injury: specific, typical or atypical for the well-known classical methods of hand-to-hand combat that law enforcement officers use. The purpose of this work was to characterize injuries in victims received during their detention by law enforcement agencies and provide their morphological and clinical analysis in order to identify ways to improve the effectiveness of these injuries’ forensic assessment in the examination of alive persons. Based on a retrospective morphological and clinical analysis of archival materials of the Kharkiv Regional Bureau of Forensic Medical Examination, the frequency and types of injuries, that were detected during the examination, of suspects injured in the course of their arrest by law enforcement agencies were determined. The features of forensic medical expert assessment in determining the mechanism, the severity of injuries associated with the detention of suspects by law enforcement agencies were defined. In the forensic medical expert practice, in the examination of alive persons when determining severity of injuries to suspects detained by law enforcement agencies, slight injuries and, in certain cases, injuries of moderate severity prevailed. The localization and the mechanism of bodily injuries formation in detained victims, in some cases, allows to qualify such injuries as specific for detention by law enforcement agencies. A further prospect of this study is the identification and justification of clear diagnostic indications for the forensic assessment of bodily injuries received by suspects when detained by law enforcement agencies that arise from the action of blunt solid, sharp objects, gunshot wounds.

Установлено особливості проведення судово-медичних експертиз при визначенні ступеня тяжкості тілесних ушкоджень за смерті постраждалих осіб із травмами під’язиково-гортанного комплексу. Проаналізовано методичне забезпечення для адекватного судово-медичного оцінювання таких травм. За аналізу чітких діагностичних критеріїв, які дозволяють об’єктивно визначати ступінь тяжкості тілесних ушкоджень при смерті осіб із травмами під’язиково-гортанного комплексу, не виявлено. Визначено шляхи подальшого вдосконалення судово-медичного оцінювання вказаних ушкоджень у випадках смерті постраждалих.

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