Postmortem radiological case series of acetabular fractures after fatal aviation accidents

Abstract

The purpose of this study was to describe radiological fracture patterns of the acetabulum sustained after fatal small aircraft aviation accidents, aiming at facilitating a better understanding of trauma mechanisms in a forensic setting. Postmortem conventional radiographs or CT scans of 29 victims of 20 small aircraft aviation accidents were analyzed for skeletal acetabular trauma. Among the 29 fatalities (27 males and 2 females, median age 55 years (range: 21–76 years)), 20 victims had pelvic fractures (69%), of which 19 victims (66%) had one or more acetabular fractures. Bilateral acetabular fractures occurred in 11 victims. When considering left and right acetabula in each victim as separate entities, 38 of the 58 acetabula included in this case series exhibited one or more fractures. Both the anterior and posterior acetabular columns were fractured in 28 acetabula. Acetabular fractures were frequently encountered in this series of 29 victims of small fatal aircraft accidents. Fractures of the acetabulum occur from ventrally directed impact (i.e. to the knee) or laterally directed impact (i.e. to the greater trochanter of the femur). Radiological descriptions of the fracture patterns can therefore aid in the forensic analysis of the mechanism of trauma in aviation accidents. Postmortem multi-slice CT scan images are preferrable in the assessment of acetabular fractures.

Management and Outcomes of Bilateral Acetabular Fractures: A Critical Review of the Literature

“…The most common fracture types in our study were ABC, AC, TPW and PW with frequencies similar to those reported in the literature [1, 45,46,[50][51][52]. PWC and T-shaped were the least common, whilst no cases with PC fractures we reported.…”

Analysis of skeletal remains from the Battle of Britain: A temporary cemetery of German aviators from World War II

“…Few studies are available that report airplane crashes in an archaeological context (Gapert & Rieder, 2013; Palmiotto et al, 2020). Most of these types of studies are reported in forensic literature (Byard & Tsokos, 2006; de Bakker et al, 2018) or consist of recent professional experiences (such as an army helicopter crash in southeast France or previously an airliner crash in the Alps), but patterns observed in soldiers are similar, especially with respect to helicopter accidents. In impact injuries, the compression of the thoracic cavity and ribs causes transverse fracture, and extension of the rachis causing the fracture of the spinous process is often observed.…”