Study of skull fractures in fatal road traffic accident cases from rural Haryana

Introduction: Head injury is an important cause of mortality throughout the worldwide. The Head region is considered as one of the most vulnerable part of the body. Therefore, it is involved frequently and lead to morbidity and mortality in road traffic accidents (RTA). Aim: The present study was thus conducted to analyze the patterns of skull fractures in fatal road traffic accident cases amongst RTA victims brought to tertiary care hospital in rural Haryana. Methods: All the cases of fatal road traffic accidents subjected to medico legal autopsy at the department of forensic medicine of MM Institute of medical sciences. The detailed analysis of these cases was based on the inquest report, medical records, if patient was admitted in the past and evaluation of autopsy reports. Results: Of total 639 medico legal autopsies were conducted during the study period, 56.81% were of RTA. Fracture of skull was present in 85%. Combination of vault and base fracture was the most common (48.23%) distribution of skull fracture. Fracture of the vault of skull alone was seen in 36.47%. Commonest type of fracture present in the skull vault was linear/fissured fracture (54.83%) constituting 68 out of 124 sites followed by comminuted fracture being 40 out of 124 sites (32.25%). Middle cranial fossa was the commonest fossa involved. 36% died within 24 hours after the accident. 33% victims survived beyond 24 hours but died within one week. Conclusion: Skull fractures are not uncommon in fatal road traffic accident cases. Combination of vault and base fracture are commonly observed. Commonest type of fracture present in the skull vault was linear/fissured fracture. Middle cranial fossa was the commonest fossa involved. Data generated here can be utilized for implementing effective emergency services to reduce the trauma related mortality of fatal accidents