An Analysis of Skeletal Trauma Patterning of Accidental and Intentional Injury

The ability to determine the cause of skeletal trauma – i.e. an injury produced by blunt, sharp, or ballistic forces - is critical in assessing the manner of death. The purpose of this study is to examine the patterns of injury between known accidental and intentional trauma cases while considering demographics, fracture features, and the location of injuries in individuals of varying ages, sexes, and ancestries. The current literature has identified a pattern for intentional injuries that is focused on the head, neck, and face, while accidental trauma tends to be more dispersed throughout the skeleton with more injuries found in the limbs.

This study used a macroscopic examination, and fractured bones were assessed by region, completeness, bone class, fracture type, mechanism of injury, and timing of injury. There were individuals of both sexes represented, as well as varying ages and ancestral groups. A total of 227 individuals were incorporated into the study with 857 individual injuries. These data were analyzed using chi-square analyses and logistic regression to discern patterns of injury.

Results indicate that the head was more frequently a target of intentional injuries than expected. Many studies cite the head and neck as the most commonly targeted sites of intentional violence. In contrast, there were more long bone injuries found in accidental trauma. These areas are particularly susceptible to accidental trauma from slips and falls, as well as an individual’s attempts to right themselves during such an event. In addition, there was a tendency to see less intentional trauma in older individuals, which may link intentional violence with younger age groups. Lastly, few significant differences existed between ancestral groups, which may show that there is a fairly equal fracture risk for intentional and accidental injuries among the groups studied.