Standardized Descriptive Method for the Anthropological Evaluation of Pediatric Skull Fractures

Abstract

The literature pertaining to pediatric skull fracture is primarily clinically based and thus motivated by the need for effective assessment of both fracture characteristics (type, frequency, location, and mechanics) and context (severity of injury, associated soft tissue damage, and prognosis). From a strictly descriptive standpoint, these schemas employ overlapping levels of detail that confound the nonclinical description of fractures in the forensic context. For this reason, application of these schemas in the forensic anthropological interpretation of skull fractures is inappropriate. We argue that forensic anthropological interpretation of skull fractures requires a standard classification system that reflects fracture morphology alone, and we suggest a three-stepped classification system that conveys increasing detail with each additional step. A retrospective application of the method to a sample of 31 children aged 1 month to 2 years demonstrated its efficacy in the description of pediatric skull fractures.

Skeletal Trauma: An Anthropological Review

“…Case reports illustrate anthropologists' success in linking cranial fracture patterns with suspect weapons. Love describes an anthropologic analysis of a cranial fracture pattern identifying a minimum of seven impact sites, consistent with strikes from an object of relatively small surface area (5). A bloodied hammer was recovered from the scene (Image 1) .…”

The Value of Anthropology in Medicolegal Death Investigation of Pediatric Nonaccidental Injury

“…One limitation recognized by researchers studying pediatric cranial fractures is inconsistency of language across studies that precludes cross study analyses. In response, Wiersema et al developed a standardized method to describe pediatric skull fractures using a three-pronged system of increased complexity (14). The first prong, Fracture Category, identified three categories applicable to all fractures: simple, complex, or comminuted.…”

An Anthropological Examination of the Types of Skeletal Fractures Resulting from Fatal High (˃3 m) Free Falls,

“…Descriptive osteology terms were primarily used to classify these fractures into types. This approach was taken as there is currently no standardized methodology for the recording and classifying of fracture types in forensic anthropology; a problem highlighted by Wiersema et al . Fracture types were classified using either biomechanical, morphological, standard anatomical location, or specific bone, descriptions.…”