Background. The study relevance is substantiated by the growing numbers of road vehicles and cervical spine traumas occurring among all spinal injuries. Currently, there is no common vision of the cervical trauma pathogenesis, diagnostic algorithm or treatment, which stipulates difficulties in the forensic evaluation of soft tissue injuries of the neck, especially combined with the head or spine traumas around neck, as well as certain diseases.Objectives. A study of the incidence of cervical spine distortion injuries and their clinical and forensic assessment for severity to human health.Methods. A retrospective selective single-stage trial and analysis of 32 forensic medical reports on road accident and physical injury administrative cases in 2017 (single year) have been conducted. Normally distributed data are presented as mean (M), standard deviation (SD) and percent shares. The significance of inter-share variation was estimated with Student’s t-test.Results. Cervical spine distortion injuries more frequently associated with traumas to drivers than passengers inside the salon (81.2%), especially in passenger vehicles, with front-seat travellers inflicted most often (60.0%). Cases of independent pathology were very rare. The most common were combinations with soft tissue injuries, combined blunt trauma to the head, torso and limbs, with craniocerebral or maxillofacial trauma. Cervical osteochondrosis was revealed in 18% cases. Primary diagnosis predominantly grounded on complaints and history (67%), with only 12% cases using a comprehensive neurological examination or instrumental methods. The severity was assessed in the context of concomitant injuries. Acute and moderate severity had equal rates of 6.2%, light severity — 37.5%, no damage — 9.3%. Non-qualified remained 39.8% cases due to a lack of full clinical and instrumental examination (66.7%) or the victim’s failure to appear (13.3%); 20% cases were expert-reported as uncertain for trauma circumstances and mechanism.Conclusion. Further research and systematisation of the data accumulated are necessary. The following clinical and forensic evaluation, as well as statistical analyses will facilitate common diagnostic and severity assessment algorithms to develop for mechanical soft tissue and ligament injuries of the cervical spine.

Background: For many years, road traffic injuries have occupied a leading position in the structure of mechanical grass in most of the leading countries of the world. Children are particularly vulnerable to road accidents due to their psychoemotional and anatomical and physiological characteristics. Aims: To study the epidemiological aspects and features of injuries with a forensic medical assessment of injuries in children in various types of road accidents in the city of Krasnodar. Material and methods: Archival medical documentation of the Department of forensic medical examination of victims, accused, and other persons of the State Budgetary Institution Bureau of SME of the Ministry of Health of the Krasnodar Territory in relation to 1,134 children under the age of 18 years who were injured in an accident on the territory of Krasnodar in 20152019; analytical, statistical, and retrospective research methods were used. Results: Children were most often injured in the summer, especially in the month of August, on the second day of the week and at night; 50% of the injured children were pedestrians; combined nature of the injury was in 38.9% of cases, and most common injuries were localized in the head (45.8%) and lower extremities (38%); the most frequent soft tissue damage in all young road users were bruises; injuries in the cabin were more common soft tissue injuries of the head; skull fractures prevailed in drivers; severe forms of traumatic brain injuries were most common in pedestrians; fractures of the limbs were detected only in older age groups, most often in pedestrians; drivers and pedestrians were more likely to have damaged shin bones, whereas passengers have it in the femur and forearm; serious health damage was detected in almost every seventh child (13.8%), most often in children under three years old and 1417 years old; and light damage in every fifth (22.1%) child and twice as often as moderate health damage (11.8%). Conclusion: The level of child road traffic injuries in the city of Krasnodar in recent years has not decreased and the negative trend of accidents related to an increased incidence of trauma in children, resulting in serious injury.

Изучены характер и степень повреждений органа зрения, придаточного аппарата и орбиты у детей и взрослых с судебно-медицинской оценкой причиняемого вреда здоровью (ВЗ) при офтальмотравме вследствие дорожно-транспортной аварийности (ДТА) в условиях крупного города РФ. Методы. Ретроспективный экспертный анализ заключений судмедэкспертов и актов судебно-медицинских освидетельствований пострадавших вследствие ДТА, выполненных в государственном «Бюро судебномедицинской экспертизы» Краснодарского края. Результаты. Для получения офтальмологической помощи в 69% случаях пострадавшим потребовалась госпитализация в стационар, остальным амбулаторная. Преобладала сочетанная травма-84,7% случаев, изолированная-12,8%. Орбитальная травма-ушибленные и ушиблено-рваные раны в каждом третьем наблюдении (61,6%), преобладала окологлазничная гематома (73%). Переломы орбиты-10,3%. В 16,7% случаев повреждения мягких тканей орбитальной области сочетались с переломами костей черепа. ВЗ от полученных повреждений, включая офтальмотравму, устанавливался по признаку длительности его расстройства: легкий-39,7%; средний-12,8%; тяжкий-30,7%, из них: по критерию опасности для жизни-62,5%, признаку стойкой утраты общей трудоспособности ≥ 1/3-37,5%. Заключение. Офтальмотравма вследствие ДТА в условиях крупного города влечет средний и тяжкий, с сопутствующей травмой, ВЗ. Необходима разработка целевой программы по оптимизации деятельности офтальмологической службы на всех уровнях оказания медицинской помощи пострадавшим при ДТА для лечения офтальмотравм и эффективной медико-социальной реабилитации для снижения случаев выхода на инвалидность по зрению. Ключевые слова: глазной травматизм; дорожно-транспортная аварийность; дети; взрослые.

Aim. To examine cases of diagnose setting for cerebral commotion after road accidents within Krasnodar city, to justify the diagnose, to analyze the level of harm committed.Materials and methods. A retrospect analysis has been done to 353 expert reports and forensic medical examination acts issued after road accidents which involved medically documented cerebral commotion. Analyzed cases have been detected by continuous sampling. Conditions taken into consideration: sex, age, circumstances, time, type of accident and type of involvement for injured people, localization and type of injury, reasons for cerebral commotion rejection from experts diagnose.Results. As a result, 199 cases have missed cerebral commotion as experts diagnose – 63.3% of these cases missed data for dynamic neurological examination of the person aggrieved, 30.7% of cases didn’t contain objective evidence of cerebral commotion, in 3.5% of cases medical outpatient card was not provided for examination by the investigator, in 2.5% of cases cerebral commotion diagnose was cancelled by clinicians after dynamic patient follow-up. In 39% of cases cerebral commotion was diagnosed in pedestrians, in 20% of cases in car drivers, in 19% of cases car passengers were injured. In nine cases (6%) there was an accident involving motorcyclists and cyclists, 4 (3%) cases were passengers of public transport. 77% of the injured people received medical care in a hospital, 23% – on an outpatient basis. In 78% of cases with cerebral commotion there were injuries of soft tissues of the head, fractures of the skull bones were revealed in 14%. Light damage to health on the grounds of a short-term disorder is established in 45% of cases, harm to health of average severity – in 20%, serious harm – in 31%, harm to health was not determined in 4%.Conclusion. The obtained results indicate that the diagnosis of cerebral commotion is established based on anamnesis and complaints, it doesn't reflect the objective symptoms of concussion. Dynamic monitoring of the course of craniocerebral trauma is not ensured, necessary laboratory and instrumental diagnostics are not carried out. It leads to the impossibility of taking this diagnosis into account when conducting forensic medical examination because of its unreasonableness.