title: Bilateral fractures of transverse processus: a diagnostic sign of overrun?
abstract: Injuries caused by traffic accidents can be complex and extensive. Due to the highly dynamic course of actions, reconstructive questions may be challenging to investigators. Differentiation of a single collision from an overrun is a central question. We hypothesized that the existence of spine fractures such as spinous and transverse processus fractures may be helpful to distinguish both. The postmortem CT-data of pedestrian fatalities were analyzed in a retrospective manner. A group finally assessed as being overrun (n=13; 7 m, 6 f, 18-86 y, mean 65 y) and a control group being hit but not overrun (n=11; 7 m, 4 f, 31-89 y, mean 61 y) were compared. Secondarily, the CT results were compared to the localization of fractures detected in routine autopsy. Cases in the overrun group showed 1-31 fractures of processus (mean 14.6) and 9 cases presented with bilateral fractures of partly opposite transverse processus. In the control group there were 6 cases without any fractures and 5 cases showed 1-9 injuries (mean 1.7). There were no bilateral fractures of transverse processus in the control group. Autopsy only detected fractures of spinous processus in 4 cases from the overrun group. Bilateral fractures of transverse processus are a possible sign for an overrun. Unilateral fractures of the transverse processus are not specific. Post-mortem CT is more sensitive for the evaluation of vertebral processus than conventional autopsy.
authors.affiliation: Institute of Legal Medicine, University of Zürich, Zürich, Switzerland. viktor.martos@irm.uzh.ch
authors.forename: V
authors.initials: V
authors.lastname: Martos
authors.forename: C
authors.initials: C
authors.lastname: Jackowski
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D055815:Young Adult