Car-to-pedestrian accident with a unique decollement injury

Stemberga, Valter; Petaros, Anja; Barišić, Anita; Čoklo, Miran; Šoša, Ivan; Bosnar, Alan

doi:10.1016/j.forsciint.2013.02.007

Cited by 11 publications

(8 citation statements)

References 4 publications

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“…In this case, a complete detachment of the skin of the left leg and foot was observed. Similar cases of degloving injuries are described in literature [11,12], but a complete skin detachment was not observed.…”

Section: Resultssupporting

confidence: 80%

A traffic accident resulting in a degloving injury of the passenger: Case report and biomechanical theory

Gitto¹,

Maiese²,

Bolino³

2013

RJLM

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A degloving injury is likely to cause minimal to extensive loss of skin with variable amounts of deep tissues loss through a defence mechanism or trauma. This injury usually occurs in vehicle-pedestrian accident victims who are run over, and less commonly one in a vehicle's passenger. In our case, three soldiers had an accident while they were travelling in a military vehicle during a reconnaissance mission. After the accident, the vehicle started to roll over several times., and the soldier who was sitting on the front passenger seat was thrown away from the vehicle and died several minutes later. At the autopsy a complete detachment of the skin of left leg and foot was observed, showing the typical features of degloving injuries. According to our reconstruction, three different forces were applied simultaneously to the body, resulting in a severe degloving injury to the leg and the foot. These methods presented here were applicable for the cause of death diagnosis in medico-legal autopsy.

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Section: Resultssupporting

confidence: 80%

A traffic accident resulting in a degloving injury of the passenger: Case report and biomechanical theory

Gitto¹,

Maiese²,

Bolino³

2013

RJLM

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“…The skin is then torn off from the underlying muscular fascia, resulting in a ‘pocket’ formation due to avulsion: a décollement traumatique is formed. 3 After skin avulsion, deep soft-tissue lacerations and the formation of a décollement , an acute herniation of abdominal organs occurs due to the increase in intra-abdominal pressure: the skin avulsion and décollement had to be formed prior to displacement of the abdominal organs. 3…”

mentioning

confidence: 99%

“…3 After skin avulsion, deep soft-tissue lacerations and the formation of a décollement , an acute herniation of abdominal organs occurs due to the increase in intra-abdominal pressure: the skin avulsion and décollement had to be formed prior to displacement of the abdominal organs. 3…”

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confidence: 99%

Re: ‘Traumatic inguinal hernia: An uncommonly reported entity’

2021

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“…However, we disagree with the mechanism reported by them.Decollement injuries are mainly produced due to being run over by a turning wheel, causing tangential force over parts of the body, leading to separation of the skin from underlying muscular fascia and causing the formation of a 'pocket' filled with blood and fat tissue. 3 Apart from this mechanism, decollement can also be produced due to oblique or tangential force applied on a person in an erect position or by applying perpendicular force during free-fall impact. 3 In the reported case, there was neither a free fall and nor was the deceased in an erect position at the time of the incident, leaving being 'run over' as the only possibility for developing a decollement injury.…”

mentioning

confidence: 99%

“…3 Apart from this mechanism, decollement can also be produced due to oblique or tangential force applied on a person in an erect position or by applying perpendicular force during free-fall impact. 3 In the reported case, there was neither a free fall and nor was the deceased in an erect position at the time of the incident, leaving being 'run over' as the only possibility for developing a decollement injury. Hence, we reiterate that the decollement injury, disruption of boundaries of the inguinal canal and subsequent herniation of the terminal ileum into the scrotal sac took place in a single event of being run over by a speeding lorry.…”

mentioning

confidence: 99%

Traumatic inguinal hernia: Exploring the possible mechanism of its causation

et al. 2021

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Dear editorWe read with interest the comments of Zivkovi c et al. 1 on our case report published in Medicine, Science and the Law entitled 'Traumatic inguinal hernia: An uncommonly reported entity'. 2 The authors have proposed an alternative mechanism of causation of traumatic inguinal hernia (TIH) in this case. We wish to thank them for showing interest in our work. However, we disagree with the mechanism reported by them.Decollement injuries are mainly produced due to being run over by a turning wheel, causing tangential force over parts of the body, leading to separation of the skin from underlying muscular fascia and causing the formation of a 'pocket' filled with blood and fat tissue. 3 Apart from this mechanism, decollement can also be produced due to oblique or tangential force applied on a person in an erect position or by applying perpendicular force during free-fall impact. 3 In the reported case, there was neither a free fall and nor was the deceased in an erect position at the time of the incident, leaving being 'run over' as the only possibility for developing a decollement injury. Hence, we reiterate that the decollement injury, disruption of boundaries of the inguinal canal and subsequent herniation of the terminal ileum into the scrotal sac took place in a single event of being run over by a speeding lorry. This possibility is also supported in the literature cited by Zivkovi c et al. 1 in which being run over was the cause for decollement injuries. 3 In run-over road traffic accidents, it is hard to predict the exact sequence of events due to the rapidity of the incident. The compression effect produced by the tyre is sufficient to produce both the shearing effect and consequent herniation of parts of the small intestine from the abdomen into the scrotal sac. In the reported case, the sudden increase in intra-abdominal pressure, along with the shearing effect on the abdominal muscle and fascia caused by the run-over, led to traumatic herniation of the small intestines. Thus, 'high-energy' impact should be considered as the cause for TIH in our case, rather than the possibility speculated by Zivkovi c et al.

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Car-to-pedestrian accident with a unique decollement injury

Cited by 11 publications

References 4 publications

A traffic accident resulting in a degloving injury of the passenger: Case report and biomechanical theory

A traffic accident resulting in a degloving injury of the passenger: Case report and biomechanical theory

Re: ‘Traumatic inguinal hernia: An uncommonly reported entity’

Traumatic inguinal hernia: Exploring the possible mechanism of its causation

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