Investigating skeletal fracture patterns in truck occupants involved in fatal motor vehicle incidents

Globally, thousands of truck occupants die annually from motor vehicle incidents. During medico-legal investigations of such incidents, forensic practitioners are required to undertake thorough examinations of the injuries present. Despite this, very few studies assessing skeletal fractures in particular, in deceased truck occupants are currently available in the literature for practitioners. Consequently, this research aimed to investigate the whole-body skeletal fracture patterns resulting from fatal truck incidents. The study group comprised 62 adult truck occupants who died in motor vehicle incidents between 2006 and 2020 and were examined at the Victorian Institute of Forensic Medicine, Australia, and the East Midlands Forensic Pathology Unit, United Kingdom. Available intrinsic and extrinsic variable information was extracted from medico-legal reports and fracture patterns were documented using associated post-mortem computed tomography scans. Descriptive and basic inferential statistics were performed to analyse the pattern and extent of fracturing, and where possible, the role of variables. The study found 97% of occupants exhibited skeletal blunt force trauma, with 94% fracturing multiple anatomical regions. The thorax (85%), followed by the skull (63%) and cervical vertebrae (56%) comprised the most fractured and fragmented skeletal regions, whilst the upper limb (23%) and pelvic girdle (31%) were fractured least often. The variables body mass index, impact velocity and truck type were associated with fracture patterning. This research provides medico-legal investigators with a greater evidence base of the fracture patterns that result from fatal truck incidents, including the patterning, complexity and quantity of fracturing, and the potential mechanisms behind them.