Skip to main content
SpringerLink
Log in

Preliminary observations of the sequence of damage in excised human juvenile cranial bone at speeds equivalent to falls from 1.6 m

  • Original Article
  • Published:
International Journal of Legal Medicine Aims and scope Submit manuscript

Abstract

There is much debate within the forensic community around the indications that suggest a head injury sustained by a child resulted from abusive head trauma, rather than from accidental causes, especially when a fall from low height is the explanation given by a caregiver. To better understand this problem, finite element models of the paediatric head have been and continue to be developed. These models require material models that fit the behaviour of paediatric head tissues under dynamic loading conditions. Currently, the highest loading rate for which skull data exists is 2.81 ms−1. This study improves on this by providing preliminary experimental data for a loading rate of 5.65 ± 0.14 ms−1, equivalent to a fall of 1.6 m. Eleven specimens of paediatric cranial bone (frontal, occipital, parietal and temporal) from seven donors (age range 3 weeks to 18 years) were tested in three-point bending with an impactor of radius 2 mm. It was found that prompt brittle fracture with virtually no bending occurs in all specimens but those aged 3 weeks old, where bending preceded brittle fracture. The maximum impact force increased with age (or thickness) and was higher in occipital bone. Energy absorbed to failure followed a similar trend, with values 0.11 and 0.35 mJ/mm3 for age 3 weeks, agreeing with previously published static tests, increasing with age up to 9 mJ/mm3 for 18-year-old occipital bone. The preliminary data provided here can help analysts improve paediatric head finite element models that can be used to provide better predictions of the nature of head injuries from both a biomechanical and forensic point of view.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

Data availability

Data is available on request to the authors.

References

  1. Johnson K, Fischer T, Chapman S, Wilson B (2005) Accidental head injuries in children under 5 years of age. Clin Radiol 60(4):464–468. https://doi.org/10.1016/j.crad.2004.09.013

    Article  CAS  PubMed  Google Scholar 

  2. Plunkett J (2001) Fatal pediatric head injuries caused by short-distance falls. Am J Forensic Med Pathol 22(1):1–12

    Article  CAS  Google Scholar 

  3. Chadwick DL, Chin S, Salerno C, Landsverk J, Kitchen L (1991) Deaths from falls in children - how far is fatal. J Trauma Injury Infect Crit Care 31(10):1353–1355

    Article  CAS  Google Scholar 

  4. Hobbs CJ (1984) Skull fracture and the diagnosis of abuse. Arch Dis Child 59(3):246–252. https://doi.org/10.1136/adc.59.3.246

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Wilkins B (1997) Head injury—abuse or accident? Arch Dis Child 76(5):393–397

    Article  CAS  Google Scholar 

  6. Reece RM, Sege R (2000) Childhood head injuries: accidental or inflicted? Arch Pediatr Adolesc Med 154(1):11–15

    CAS  PubMed  Google Scholar 

  7. Roach JP, Acker SN, Bensard DD, Sirotnak AP, Karrer FM, Partrick DA (2014) Head injury pattern in children can help differentiate accidental from non-accidental trauma. Pediatr Surg Int 30(11):1103–1106. https://doi.org/10.1007/s00383-014-3598-3

    Article  PubMed  Google Scholar 

  8. Williams R (1991) Injuries in infants and small children resulting from witnessed and corroborated free falls. J Trauma Acute Care Surg 31(10):1350–1352

    Article  CAS  Google Scholar 

  9. Loyd AM (2011) Studies of the human head from neonate to adult: an inertial, geometrical and structural analysis with comparisons to the ATD head. Citeseer

  10. Hajiaghamemar M, Lan IS, Christian CW, Coats B, Margulies SS (2018) Infant skull fracture risk for low height falls. Int J legal Med 1-16

  11. Li X, Sandler H, Kleiven S (2019) Infant skull fractures: accident or abuse?: Evidences from biomechanical analysis using finite element head models. Forensic Sci Int 294:173–182

    Article  CAS  Google Scholar 

  12. Burgos-Flórez F, Garzón-Alvarado DA (2020) Stress and strain propagation on infant skull from impact loads during falls: a finite element analysis. Int Biomech 7(1):19–34

    Article  Google Scholar 

  13. Margulies SS, Thibault KL (2000) Infant skull and suture properties: measurements and implications for mechanisms of pediatric brain injury. J Biomech Eng 122(4):364–371. https://doi.org/10.1115/1.1287160

    Article  CAS  PubMed  Google Scholar 

  14. McPherson GK, Kriewall TJ (1980) The elastic modulus of fetal cranial bone: a first step towards an understanding of the biomechanics of fetal head molding. J Biomech 13(1):9–16

    Article  CAS  Google Scholar 

  15. Wang J, Zou D, Li Z, Huang P, Li D, Shao Y, Wang H, Chen Y (2014) Mechanical properties of cranial bones and sutures in 1–2-year-old infants. Med Sci Monit 20:1808

    Article  Google Scholar 

  16. Davis MT, Loyd AM, Shen H-yH, Mulroy MH, Nightingale RW, Myers BS, Bass CD (2012) The mechanical and morphological properties of 6 year-old cranial bone. J Biomech 45(15):2493–2498. https://doi.org/10.1016/j.jbiomech.2012.07.001

    Article  PubMed  Google Scholar 

  17. Coats B, Margulies SS (2006) Material properties of human infant skull and suture at high rates. J Neurotrauma 23(8):1222–1232. https://doi.org/10.1089/neu.2006.23.1222

    Article  PubMed  Google Scholar 

  18. Brooks T, Choi JE, Garnich M, Hammer N, Waddell JN, Duncan W, Jermy M (2018) Finite element models and material data for analysis of infant head impacts. Heliyon 4(12):e01010

    Article  Google Scholar 

  19. Ommaya A, Goldsmith W, Thibault L (2002) Biomechanics and neuropathology of adult and paediatric head injury. Br J Neurosurg 16(3):220–242

    Article  CAS  Google Scholar 

  20. Anjomrouz M (2017) Investigation of MARS spectral CT: X-ray source and detector characterization. University of Otago

  21. Bateman CJ (2015) Methods for material discrimination in MARS multi-energy CT. University of Otago

  22. Matanaghi A, Raja A, Leary C, Amma MR, Panta R, Anjomrouz M, Moghiseh M, Butler A, Bamford B, Collaboration M (2019) Semi-automatic quantitative assessment of site-specific bone health using spectral photon counting CT. J Nucl Med 60(supplement 1):1297

    Google Scholar 

  23. Schneider CA, Rasband WS, Eliceiri KW (2012) NIH Image to ImageJ: 25 years of image analysis. Nat Methods 9(7):671–675

    Article  CAS  Google Scholar 

  24. Schindelin J, Arganda-Carreras I, Frise E, Kaynig V, Longair M, Pietzsch T, Preibisch S, Rueden C, Saalfeld S, Schmid B (2012) Fiji: an open-source platform for biological-image analysis. Nat Methods 9(7):676–682

    Article  CAS  Google Scholar 

  25. Photron (2019) Photron FASTCAM Viewer. 4.0.2.2 edn

  26. Baumer TG, Passalacqua NV, Powell BJ, Newberry WN, Fenton TW, Haut RC (2010) Age-dependent fracture characteristics of rigid and compliant surface impacts on the infant skull—a porcine model. J Forensic Sci 55(4):993–997

    Article  Google Scholar 

  27. Loyd AM, Nightingale RW, Luck JF, Song Y, Fronheiser L, Cutcliffe H, Myers BS, Bass CRD (2015) The compressive stiffness of human pediatric heads. J Biomech 48(14):3766–3775

    Article  Google Scholar 

  28. Kieser J (2012) Biomechanics of bone and bony trauma. In: Kieser J, Taylor M, Carr DD (eds) Forensic biomechanics. vol Book, Whole. Wiley-Blackwell, Chichester

    Chapter  Google Scholar 

  29. Delye H, Clijmans T, Mommaerts MY, Sloten JV, Goffin J (2015) Creating a normative database of age-specific 3D geometrical data, bone density, and bone thickness of the developing skull: a pilot study. J Neurosurg Pediatr 16(6):687–702

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Dr Marzi Anjomrouz from MARS Bioimaging Ltd. for her help with the spectral CT imaging of the specimens.

Funding

T Brooks is the recipient of a University of Canterbury Doctoral Scholarship.

Author information

Authors and Affiliations

  1. Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand

    Tom Brooks & Mark Jermy

  2. Department of Anatomy, University of Otago, Dunedin, New Zealand

    Johann Zwirner

  3. Department of Macroscopic and Clinical Anatomy, Medical University of Graz, Graz, Austria

    Niels Hammer

  4. Department of Orthopedic and Trauma Surgery, University of Leipzig, Leipzig, Germany

    Niels Hammer

  5. Fraunhofer IWU, Dresden, Germany

    Niels Hammer

  6. Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Benjamin Ondruschka

Authors
  1. Tom Brooks
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Johann Zwirner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Niels Hammer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Benjamin Ondruschka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mark Jermy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mark Jermy.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Code availability

No relevant code was used in the preparation of this work.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Tom Brooks and Johann Zwirner are young researchers.

Appendix

Appendix

Fig. 8
figure 8

Maximum impact force versus age (with uncertainties)

Full size image
Fig. 9
figure 9

Energy absorbed to failure versus age (with uncertainties)

Full size image

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brooks, T., Zwirner, J., Hammer, N. et al. Preliminary observations of the sequence of damage in excised human juvenile cranial bone at speeds equivalent to falls from 1.6 m. Int J Legal Med 135, 527–538 (2021). https://doi.org/10.1007/s00414-020-02409-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-020-02409-7

Keywords

Search

Navigation