Death scene investigation and autopsy proceedings in identifying the victims of the terror attack on the Breitscheidplatz in Berlin 19th December 2016

We describe and discuss the forensic mission after the terrorist attack on the Breitscheidplatz in Berlin on 19th December 2016, focusing on co-operation with police authorities, and the injury patterns of the deceased. Even after massive blunt trauma, severe injury patterns are often unrecognizable by visual inspection of the body (“Casper’s sign”), which could instill false security among rescuers or, as happened on the Breitscheidplatz, may lead to distress or even trauma in rescue personnel when obviously primarily uninjured patients die suddenly

Effects of Foot Type on Multi-Segment Foot Motion in High- and Low-Arched Female Recreational Athletes

Introduction: Mal-alignment and dysfunction of the foot have been shown to result in an increased rate of injury and unique injury patterns. Aberrant foot function has been shown to contribute to repetitive stress and acute injuries. High-arched athletes have been shown to experience a greater rate of bony injury to the lateral aspect of the lower extremity while low-arched athletes experience greater rates of soft-tissue injury to the medial aspect of the lower extremity. Though foot type has been linked to these injury patterns, the mechanism by which these injury patterns occur remains unknown. Multi-segment foot models have been developed and allow for direct examination of motion within the foot. Therefore, the purpose of the current studies is to directly examine motion within the foot during vertical loading and dynamic loading tasks. Methods: Ten high- and 10 low-arched female athletes performed five trials in each of the following randomized conditions: walking, running, downward stepping, landing and a sit-to-stand exercise. Three-dimensional kinematics and ground reaction forces were collected simultaneously using a 7-camera motion capture system and force platform, respectively. Results: The HA athletes were less everted than the LA athletes in the ankle and mid-forefoot joints in all activities. The HA and LA athletes exhibited similar excursion values in all joints. Additionally, the HA athletes had a greater arch index and greater arch deformity during in the sit-to-stand task. Discussion and Conclusions: The HA athletes are less everted in all movements than the LA athletes; however excursion values were similar between the two groups. These data suggest the reason for different injury patterns within these two groups is not due to greater frontal plane ranges of motion. Furthermore, the sit-to-stand exercise showed that the HA athletes have a greater arch index but have greater deformation in response to a vertical load. The LA athletes exhibited less arch deformity but this deformity appears to be limited by the floor. The current study suggests the mechanism leading to different injury patterns in the HA and LA athletes is vertical compression of the arch

Injury patterns of medial meniscus posterior root tears

INTRODUCTION: Medial meniscus posterior root tear (MMPRT) can occur in middle-aged patients who have a posteromedial painful popping during light activities. MMPRTs are more common in patients with increased age, female gender, sedentary lifestyle, obesity, and varus knee alignment. However, injury mechanisms of minor traumatic MMPRTs are still unclear. We hypothesized that high flexion activities are the major cause of MMPRTs. The aim of this study was to clarify injury patterns of MMPRTs. MATERIALS AND METHODS: One hundred patients were diagnosed having MMPRTs after posteromedial painful popping episodes. Details of posteromedial painful popping episode, situation of injury, and position of injured leg were obtained from the patients by careful interviews. Injury patterns were divided into 8 groups: descending knee motion, walking, squatting, standing up action, falling down, twisting, light exercise, and minor automobile accident. RESULTS: A descending knee motion was the most common cause of MMPRTs (38%) followed by a walking injury pattern (18%) and a squatting action related to high flexion activities of the knee (13%). The other injury patterns were less than 10%. DISCUSSION: Descending knee motions associated with descending stairs, step, and downhill slope are the most common injury pattern of MMPRTs. High flexion activities of the knee are not the greatest cause of MMPRTs. Our results suggest that the descending action with a low knee flexion angle may trigger minor traumatic MMPRTs

The blast pelvis

Decreasing the human cost of war is a vital role within the Ministry of Defence, and the Defence Medical Services. With the considerable improvements in care, from point of wounding to rehabilitation, it is possible that we have reached the ceiling of optimal management with available, deployed resources. Injury prevention or mitigation may therefore have a more important role than ever in improving survival rates. The current character of conflict, and certainly the recent conflicts in Iraq and Afghanistan have seen the Improvised Explosive Device used to devastating effect to personnel. These devices cause multisystem injuries, and have a high fatality. The lower extremity was most often affected in these recent conflicts, and many fatalities occurred. A greater understanding of lower extremity trauma biomechanics is likely to be key to preventing future fatalities due to injuries in this body region. This thesis focusses on lower extremity blast injury, performs a review of current understanding, and undertakes a casualty data analysis to further understand injury patterns and the cause of fatal wounding. This analysis finds that haemorrhage secondary to pelvic fracture is the key factor in fatal lower extremity injuries, and therefore an area of considerable research interest. Pelvic injury patterns were therefore analysed using measurement techniques to qualify injury patterns and understand the link between injury patterns and the presence of vascular injury. Subsequent physical and computational testing provided a platform to apply different loading conditions to the pelvis to replicate a blast injury, and understand the behaviour of the bony structures under high rate axial loading. This thesis concludes that the anterior pelvic ring at the pubic symphysis is key to pelvic integrity at high rates of loading. Disruption of the anterior pelvis can lead to subsequent posterior ligamentous rupture which, due to the proximity to major vessels, can lead to major haemorrhage and death. Preventing lateral disruption may be the key to maintaining pelvic integrity at these high loading rates, and preventing vascular compromise and fatality from lower extremity blast injuries.Open Acces

Gender differences in limb and joint stiffness during the fencing lunge

The aim of the current investigation was to examine gender differences in limb and joint stiffness characteristics during the fencing lunge. Ten male and ten female fencers completed simulated lunge movements. Lower limb kinematics were collected using an eight camera optoelectric motion capture system which operated at 250 Hz. Measures of limb and joint stiffness were calculated as a function of limb length and joint moments divided by the extent of limb and joint excursion. Gender differences in limb joint stiffness parameters were examined statistically using independent samples t-tests. The results showed firstly that both limb (male = 64.22 ±19.12, female = 75.09 ±22.15 N.kg.m) and hip stiffness (male = 10.50 ±6.00, female = 25.89 ±15.01 Nm.kg.rad) were significantly greater in female fencers. In addition it was also demonstrated that knee moment (male = 1.64 ±0.23, female = 2.00 ±0.75 Nm.kg) was significantly larger in females. On the basis of these observations, the findings from the current investigation may provide further insight into the aetiology of the distinct injury patterns observed between genders in relation to fencing

Ankara bombing : distribution of injury patterns with radiological imaging

Purpose: To describe and explain the blast injuries and imaging findings in the Ankara terrorist explosion that took place on October 10, 2015. Material and methods: A total of 77 patients who underwent radiologic imaging were classified as primary, secondary, tertiary, and quaternary, according to the injury type. The patients were evaluated based on body regions, such as head and neck, thorax, abdomen, lower extremity, and upper extremity. Results: Blast lung injury was identified in one patient and tympanic membrane perforation in seven patients, as the primary injury. Sixty-two of 77 patients had secondary blast injuries caused by shrapnel. The blast injuries were observed in the head and neck (16/77, 20.7%), thorax (11/77, 14.2%), abdomen (16/77, 20.7%), lower extremity (48/77, 62.3%), and upper extremity (5/77, 6.4%). Vascular injuries were seen in eight cases, of which seven were in the lower extremities. Conclusions: The most common blast injury pattern was of a secondary type in the current study. Lower extremities were the significantly more affected body region, probably due to the bomb exploding at ground level. In mass casualty events, radiologic imaging is located at the centre of patient management

The injury patterns in pole sports athletes in Gauteng

Abstract: Purpose: To determine the types of injuries occurring in pole sports athletes in Gauteng. In addition, this study aimed to identify potential risk factors that may have predisposed certain athletes to developing musculoskeletal injuries. Risk factors such as: age, weight, skill level, frequency of training and the duration of training were investigated. Method: A questionnaire-based quantitative study was conducted in order to establish the injury patterns occurring in 100 pole sports athletes in Gauteng. A pilot study was used to test the questionnaires before commencing the data collection. Participants were recruited at their pole sports studios after permission was granted by the studio owners. The information letters, consent forms and questionnaires were distributed and completed in hard copy format. The questionnaires were completed anonymously and the participants were free to withdraw from the study at any time before they handed in their completed questionnaire. Once the data collection was completed, a statistician was consulted in order to assist with the data analysis. Results: The majority of the study participants (58%) sustained an injury as a direct result of participating in pole sports. The greatest proportion of the injuries sustained were muscle strains (58%) followed by ligament sprains (29%). The most commonly injured region of the body was the upper limb (41,6%). The risk factors identified that predisposed participants to sustaining a musculoskeletal injury were: skill level, duration of training per day and frequency of training per week. Additionally, the number of years of participation also presented as a risk factor in this study. Conclusion: Injury occurrence was prevalent in this study population, with the upper limb being the most commonly injured body region. The injury patterns were not in accordance with a similar study conducted internationally; however, the setting for these two studies was vastly different which could therefore explain the differences noted between the data collected by each study.M.Tech. (Chiropractic

A COMPARISION BETWEEN STATIC AND DYNAMIC FOOT MOBILITY MAGNITUDE MEASURES

Traditional methods used to assess foot posture during dynamic activities rely on static measures of foot dimensions during partial weight bearing. In recent years, evidence was found which links musculoskeletal and overuse injury patterns in athletes to foot posture. To be able to accurately assess the relationship between injury patterns and foot posture, it might be necessary to study changes in the foot posture during the dynamic activities that the athlete normally undertakes. The purpose of this research is to introduce a method which can be used to measure changes in the foot posture during dynamic activities, hence providing a better prediction of the changes in the foot posture and its relationship to lower limb injuries. The results from static and dynamic Foot posture measures were compared for two subjects and the results showed significant differences