Bone bruises—a rarely observed phenomenon at autopsy
摘要
Bone bruises or occult bone lesions, are well-documented in sports medicine and trauma surgery but were so far not in the focus of forensic diagnostic methods and received only marginal attention in forensic practise. This is surprising as these microtrabecular fractures caused by compressive forces, can provide crucial forensic evidence, particularly in cases where external injuries are minimal or absent. Despite their potential significance in trauma reconstruction, forensic reports of bone bruises remain limited. We investigated five cases with evidence of bone contusions under different circumstances. An unidentified mummified and putrefied male found in an abandoned area (case 1); a young male homicide victim with fatal craniocerebral trauma (case 2); a young male who sustained a fatal head injury in a head-on motorcycle collision with a highway pole (case 3); a male railway accident victim with multiple injuries (case 4) and a young male, side passenger in a hatchback, involved in a fatal head-on collision with a loaded truck on a busy highway (case 5). While bone bruises were identified on the skull in cases 1, 2 and 3, well-marked femoral bruises were detected in cases 4 and 5. The bruises showed dark focal discolorations of the bone surface with associated linear fissures or fractures at autopsy. This case series demonstrates the forensic utility of bone bruises and their great potential in reconstruction of trauma events and direction of impact sites with greater accuracy. Further studies using standardized protocols and including additional techniques such as diaphanoscopy, micro-CT or histopathology are needed to better understand the reconstructive significance of bone bruising in the forensic investigation of trauma.