FORENSIC MEDICAL EXAMINATION OF LETHAL OUTCOMES OF COMBINED LIMB INJURIES ASSOCIATED WITH THERAPEUTIC AND DIAGNOSTIC INTERVENTIONS

Аннотация

The purpose of the study was to identify the features of a forensic medical examination in case of fatal outcomes of a concomitant limb injury after medical and diagnostic measures. Materials and research methods. The data of medical records, the results of laboratory and additional studies, as well as the conclusions of the FMS of corpses, were analyzed in relation to 434 persons aged 13 to 78 years with TS admitted from hospitals. The majority of those who died from ST were men of the most able-bodied age from 18 to 60 years. The results obtained: in the composition of ST, closed and open TBI with damage to the structure of the facial region (92.3%) prevailed, followed by damage to the structure of the chest (66.3%), abdomen (52.5%) and extremities (35.0%) with a predominant lesion of the bones of the lower extremities (102 out of 152). It was noted that the outcomes of treatment of patients with ST in the extremities largely depend on the duration, volume and qualification of the medical care provided. Fractures of the bones of the lower extremities in the late stages of TS are most often complicated by deep vein thrombosis and pulmonary embolism, fat embolism of the brain and lungs, which are the direct cause of death in patients with TS. It is emphasized that these states are not always taken into account to justify thanatogenesis in the process of SME of corpses. Conclusions. After carrying out medical and diagnostic interventions, in the process of examination of corpses with ST of the limbs, full-fledged studies of the state of organs and tissues are not always carried out to substantiate thanatogenesis. Practically no attention is paid to the complications and errors of medical and diagnostic interventions. In addition, complications of osteosynthesis procedures such as delayed union, secondary fractures, secondary displacement of bone fragments, migration and fracture of structures are not always detected. To substantiate the mechanism and thanatogenesis of TS with damage to the structure of the limbs, a qualified examination of corpses is required with the obligatory forensic histological examination of organs and tissues.