Forensic medical characteristics of fractures of the bones of the hand

Abstract

Rationale. The study of forensic aspects of fractures of the bones of the hand is of particular interest in connection with the need to establish the nature, mechanism of occurrence, severity and duration of these injuries. The purpose of the study was to assess the severity of the harm caused to health based on the study of the formation, course and outcomes of fractures of the bones of the hand. Research materials. Fractures of the bones of the wrist (24) and metacarpal bones (218) have been studied in persons affected by the impact of blunt objects. Results. It was found that fractures of the scaphoid bone (81.8%) are most often formed on the side of the carpal structure, fractures of other carpal bones are detected relatively less frequently (18.2%). With fractures of the navicular bone, especially in cases of late seeking medical help, complications can occur in the form of a false joint and aseptic necrosis, causing a pronounced dysfunction of the wrist joint. In the metacarpal bones, periarticular fractures of the proximal epiphysis (49.1%) are often noted, then intraarticular fractures (26.6%), periarticular diaphyseal fractures of the body (20.6%). Complications in the form of contracture of the fingers in the long-term period of fractures of the metacarpal bones were most observed in intra-articular, comminuted with mixing and transverse fractures. Conclusion. Isolated uncomplicated fractures of the bones of the wrist are classified as moderate. At the same time, fractures of the scaphoid bone, complicated by a false joint and aseptic necrosis, causing severe dysfunction of the wrist joint, up to immobility in a functionally disadvantageous position, according to the criterion for the loss of permanent loss of total disability over 1/3 (35-40%), is classified as severe injuries.