No abstract

Fractures of the posterior ribs are well-recognized sequelae of infant abuse. Previous reports have indicated a predilection for fracture near the costotransverse process. This study expands the spectrum to include fractures involving the rib head. The radiologic and histologic features are described, and the mechanism of injury of this lesion is examined. In situ and specimen radiography, followed by histopathologic examination, was performed in 78 ribs removed from seven abused infants who died with posterior rib fractures. Computed tomography of the intact posterior thorax was performed in two of these infants. Fifty posterior rib fractures were identified; 29 involved the rib head. Frontal radiography was insensitive in identifying these fractures, clearly revealing injury only when periosteal reaction was present (four of 29 cases). Axial specimen radiography delineated the fractures in all cases. In the two infants studied, CT depicted five of 19 fractures visible only with axial specimen radiography. The morphologic features of these fractures further support the concept that most fractures in abused infants occur by means of indirect forces and are consistent with anteroposterior manual thoracic compression during assaults.

A worker died after a witnessed fall from an 8-foot ladder. Autopsy revealed an unexpected penetrating wound to the hard palate. This report details the importance of the forensic autopsy in reevaluating the scene.

No abstract

Atypical gunshot wounds of entrance occur when bullets deviate from their stable nose-on trajectory before entering the body. When this occurs, the resulting wound may have an atypical D-shaped appearance. Ray-like abrasions or bruises may radiate from the corners of the wound. Unstable nonaxial flight may be caused by intermediate targets, ricochets, inappropriate weapon/ammunition combinations, poor weapon construction, or use of misaligned silencers. If a bullet is deformed before entrance the configuration of the resulting wound may be bizarre, and the wound configuration may closely resemble the configuration of the striking bullet. Nine cases are presented showing the effects of various intermediate targets. A number of methods for the investigation of atypical wounds are discussed.