Biology Reference
In-Depth Information
individuals' names and dates of birth are obscured. Even though the “patients” are deceased,
forensic records are medical records, and any violation of HIPAA, even in the context of
forensic research, is a federal offense punishable by a fine or jail term. If doing your research
in a country other than the United States, similar laws or standards may exist. Following the
advice above will prevent any potential problems.
Other Considerations
Utilizing radiographs, other medical images, and national databases is another avenue for
conducting trauma research using a case-based approach. While not traditionally used in
forensics, these resources can contain a wealth of information. The best places to investigate
these types of research projects are often in conjunction with the medical community. While
in these cases, the benefit of actually examining the bone specimen does not exist, plain film
radiographs as well as CT scans of patients with known injuries can provide a wealth of data
into fracture pattern characteristics. See Moore [Chapter 14], this volume, for more on
medical imaging technologies.
CASE STUDY: INVESTIGATION OF FRACTURE PATTERNS IN CHILD
ABUSE USING A CASE-BASED APPROACH
Investigations in alleged child abuse are often a very delicate and sensitive subject for
forensic pathologists, anthropologists, and law enforcement. To aid in the correct assessment
of injuries in a child to make a determination of suspected abuse, the pathologist or anthro-
pologist often relies on a suite of evidence, including multiple fractures showing different
chronological episodes of abuse and fracture patterns (a pattern of abuse over time) indica-
tive of assault type(s) of injury (
Symes et al., 2002
).
Mandibular fractures in children, especially young children who are not yet walking, are
often very indicative of child abuse (
Hobbs, 1984
). These fractures commonly occur when an
abuser strikes a child in the face, anddue to the developing shape and structure of themandible
themost common location for fracturewill be in the area belowthemandibular condyle. To look
at the occurrence of these types of fractures in known cases of abuse, a case analysis approach
was used. Kroman and colleagues (2002) used a large forensic sample that they queried for
cases of known abuse in children under two years of age. Out of the sample, four cases meeting
the criteriawere identified. Of these four cases, two had fractures of themandibular condyle. In
one case the fracture was acute, and associated with fractures of the frontal bone and rib frac-
tures. In the other case, there were numerous acute fractures as well as fractures in various
stages of healing. The mandibular condyle fracture and several rib fractures showed healing,
which also helped to demonstrate a pattern of abuse (
Kroman et al., 2002
).
In this example, the research question best lent itself to a case-based analysis approach
rather than an experimental design. While the sample size was small, this was expected
when dealing with known and established cases of child abuse, as the aim was more in
line with making descriptive conclusions rather than conclusions backed up by statistical
analysis. For more information on child abuse and skeletal analysis, see the volumes by
Love et al. (2011)
and
Ross and Abel (2011)
.
