Kantonsspital St.Gallen

Morphology of direct and indirect rib fractures

Steffen Kissling & Roland Hausmann

abstract Rib fractures are a common finding in legal medicine and information on the impact mechanism is relevant for trauma reconstruction.
This study focuses on morphological characteristics of rib fractures resulting from direct or indirect force. Fresh human
ribs (n = 312) were divided into two groups and broken through local force (direct) and bending (indirect) in anterolateral areas.
The ribs were macerated, visually investigated and the results statistically analysed. The indirect fractures showed a significant
larger lateral offset of the internal and external fracture ends while the fracture ends of the direct fractures were more often
straight, in line. Also, the morphology of the inner and outer fracture edges was significantly related to fracture type. Direct
fractures mostly had rough and jagged inner edges (tension side) and straight, smooth outer edges (compression side), whereas
indirect fractures more often showed the characteristics vice versa. The results were more convincing in combination and in ribs
from persons aged ≤ 75 years at death. In summary, the direct and indirect rib fractures showed significantly different characteristics
regarding orientation and offset of the fracture lines and roughness of the inner and outer fracture edges, which can be
helpful to distinguish the traumatizing impact mechanisms in forensic autopsy routine.
citation Kissling S, Hausmann R. Morphology of direct and indirect rib fractures. International Journal of Legal Medicine 2020;.
type journal paper/review (Deutsch)
date of publishing 14-9-2020
journal title International Journal of Legal Medicine
publisher Springer
DOI 10.1007/s00414-020-02428-4
contact Steffen Kissling