SUMMARYA body of a 91-year-old donor underwent whole-body CT scanning before being transferred for use in an anatomical dissection course. Metallic objects were detected in the thigh muscles, extensive bone abnormalities were found in the left femur and the diaphysis of the left femur was 50% wider than that of the right diaphysis. History revealed that the body donor had been seriously wounded at the end of World War II by a rocket explosion. His multiple fractures and lesions had not been surgically treated either in an Austrian military hospital or in a French prisoner of war camp. The patient suffered for almost 70 years from this violation of the Geneva Conventions. In the light of current armed conflicts, the present case is an example of how one injustice can result in severe, lifelong medical consequences. It also shows that the history behind a wounded thigh can have an enormous impact on teaching ethics to today's medical students.
CASE PRESENTATIONA man aged 91 at time of his death was, in accordance with his will, embalmed and his body donated to our medical faculty for use in the anatomical dissection course. As a part of our teaching concept, whole-body CT and MRI scanning is performed on every other donated body in order to teach radiological anatomy using images of the same bodies that are dissected.1 During routine CT scanning of this 91-year-old donor body, various small metallic objects (later identified as shrapnel fragments) were detected in the right gracilis muscle and the left gluteus maximus muscle. On CT scanning, extensive bone abnormalities were also found in the left proximal femoral bone and the greater and lesser trochanters (figures 1 and 2).To obtain a better view of the extent of the changes, three-dimensional (3D) reconstruction of the CT images was performed. The 3D reconstruction (figure 2) shows massive bone remodelling as well as differences in trabecular and cortical architecture in the left compared to the right proximal femur. Two shrapnel fragments can also be seen above the left femoral shaft and in the right adductorial muscles (green arrows in figure 2). The metallic fragments seen on CT imaging were located and removed during the dissection course. The proximal left femur was largely connected with the surrounding soft tissue and muscles. Twelve weeks of warm water and enzymatic maceration of both lower limbs allowed comparison of the bones. The diameter of the left femoral diaphysis was 50% wider than that of the right femoral diaphysis. Additionally, the trabecular and cortical architecture was distinctively altered and the left lesser trochanter was completely destroyed ( figure 3).A history obtained from the widow and daughter of the donor revealed he had been seriously wounded on the Eastern Front at the end of World War II, probably by a nearby rocket explosion. The soldier had been taken to an Austrian military hospital, which was shortly afterwards captured by Allied troops. Thereafter, the wounded man became a prisoner of war in France. In 1948, 3 years aft...
