儿童病理性骨折伤残鉴定1例

Disability Identifi cation of Pathological Fracture in Children:A Case Report

儿童病理性骨折发病隐匿,病变部位骨质薄弱,常在遭受外力后确诊为病理性骨折,通常情况下骨折线位于肿瘤部位。儿童病理性骨折伤残等级鉴定较为少见,这类案件在法医临床鉴定活动中争议较大,损伤与疾病共存情况下,如何评定伤残等级及伤病关系处理是该类案件的难点。笔者结合一个儿童病理性骨折案例,分别从病历资料完整性、影像学资料选择、DICOM文件使用、鉴定时机选择、伤病关系处理五个方面总结鉴定过程中需注意的要点,为之后相似的鉴定活动提供参考。

Pathological fractures in children have an insidious onset,and the bone quality of the lesion site is weak,often diagnosed as pathological fracture after being subjected to external force,and usually the fracture line is located in the tumor site.Children’s pathologic fracture disability rating is relatively rare,and this kind of case is more controversial in the forensic clinical appraisal activities.Injury and disease coexistence,how to assess the disability rating and the relationship between injury and disease treatment is the diffi culty of this kind of case.In the paper,the author reviewed this case from the completeness of the medical record data,the choice of imaging data,the use of DICOM fi les,identifi cation of the timing of the choice,and the relationship between injuries and diseases.The key points were noted during children’s pathologic fracture identifi cation process which serve as a reference for similar cases.