64 Characteristics of Femoral Fractures and Accompanied Rall-Related Injuries

Abstract

detected by colposcope digital imaging compared to those injuries detected using a high-resolution camera system.Methods: This was a retrospective, before-and-after trial to assess genital injuries in consecutive adult (˃16 years old) women presenting after sexual assault to a freestanding nurse examiner clinic (NEC) during a 3-year study period. The clinic is staffed by forensic clinicians trained to perform medical-forensic examinations using colposcopy with nuclear staining and digital imaging. Patients evaluated in 2015-2016 had all injuries documented using a Cooper Surgical Leisegang© colposcope system; those seen in 2018 had injuries documented using only the high-resolution camera system. The primary outcome of interest was the frequency of genital findings documented in sexual assault victims from each group. Descriptive statistics were used to summarize the frequency of anogenital injury, location, and type of injury (abrasion, laceration, erythema, ecchymosis, and edema). Chi-square and ANOVA tests were used to compare the two study groups (standard colposcopy vs high-resolution camera system).Results: A total of 367 women were evaluated during the "before" period and 180 in the "after" period. The two groups were comparable in terms of demographics, alcohol use, assault history, time interval to examination, and the frequency of genital injuries (76.1% vs. 74.9%, p¼0.76). Patients examined using the high-resolution camera system had a significantly greater number of mean genital injuries documented (2.4 vs. 1.8, p <0.001). The women in this group also had significantly more anogenital abrasions identified (51.1% vs. 27.0%, p <0.001). The overall injury pattern was not statistically different; common sites of injury in both groups were posterior, including the fossa navicularis, fourchette, and labia minora.Conclusions: Accurate photo-documentation is a standard of forensic care. Our results suggest that identification of anogenital injuries varies depending on the type of imaging system utilized.