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a0010 Biomechanics of Bone Trauma

Au3 DJ Wescott, Texas State University, San Marcos, TX, USA
ã 2013 Elsevier Ltd. All rights reserved.

Glossary Plastic deformation Permanent strain that is unrecoverable dt0055

dt0010 Anisotropic A characteristic of a material that has different when the bone is unstressed. Plastic deformation occurs
mechanical properties when loaded in different directions between the yield point and the failure point.
due to its directional structure. Remodeling The removal and replacement of bone at a dt0060

dt0015 Bending (angulation) A mode of loading such that the particular location by the coupled action of osteoclasts
bone bends around its axis and experiences tension on the (bone-destructing cells) and osteoblasts (bone-building
convex surface and compression on the opposite concave cells).
surface. Stiffness (rigidity) The ability of a material to resist dt0065

dt0020 Brittle Characteristic of a material that readily breaks deformation or the load required to cause bone to deform a

F
without plastic deformation when subjected to stress. given amount. It is measured as the slope of the stress–strain
dt0025 Buttressing Areas of struts or thickening of the bone. curve and influenced by the relative proportion of collagen

O
dt0030 Compliance A measure of the ease with which bone and hydroxyapatite crystals.
deforms or the inverse of stiffness. Strain The dimensional change in loaded bone. dt0070

O
dt0035 Compression A mode of loading where the forces are acting The principal strains are normal or shear.
in opposite directions along the longitudinal axis of the Strength The ability of bone to withstand permanent dt0075

R
bone. Compression results in a decrease in length and an deformation (the load at the yield point) or fracture
increase in width. (the load at failure point).
Stress The load per unit area of a bone, measured in

P
dt0040 Ductility The ability of a material to deform under tensile dt0080

stress. Pascal (Pa). The stress can be normal or shear.

dt0045 Elastic deformation Deformation or strain in bone that is Tension A mode of loading in which the forces act in dt0085
T
reversible when the stress is released. opposite directions along the longitudinal axis of the bone.
dt0050 Elastic modulus (Young’s modulus) The ratio of stress to Tension results in an increase in length and decrease
S

strain in the elastic region of deformation. Because of the in width.

anisotropic nature of bone, the moduli in compression and Yield point The point where bone begins to deform dt0090
IR

tension differ in bone or the slope of the stress–strain curve. plastically.

F

Au2 s0010 Introduction among these agents are primarily determined by the size of the
impact area and the magnitude and duration of the force.
R

p0010 Biomechanics is the science of mechanical laws applied to Indirect trauma results in injury at locations other than the
biological tissue. Trauma is an extrinsic agent, force, or mech- point of impact or applied force. Stress and pathological inju-
IE

anism that causes injury or shock to a living tissue, usually due ries are associated with repetitive forces or disease processes,
to violence or accident. Hence, the biomechanics of bone respectively, that weaken bone. This article will primarily focus
trauma is the application of mechanical laws to describe and on fractures or disruptions in the structural continuity of the
V

interpret bone trauma, and involves the examination of both bone due to direct mechanical trauma.
the intrinsic (size, geometry, and material properties such as
E

stiffness, elasticity, and density) and extrinsic (magnitude, du-

ration, and direction of force) factors resulting in bone injury.
S

Understanding the biomechanics of bone trauma allows Goals of Trauma Analysis s0015
forensic scientists to use the pattern of bone fractures to deduce
L

the type and direction of loading that caused the bone to fail. The goals of trauma analysis in a medicolegal situation are to p0020
E

This information then often can be used to determine proxi- determine the proximate (i.e., immediate mechanism) and
mate and ultimate cause of the injury. ultimate (e.g., manner of death) causes of the trauma. This is
p0015 Injuries to bone usually involve fracture (failure) or dislo- necessary to aid in determining the cause and manner of death
cation (displacement at a joint). The mechanisms of fractures by the medical examiner. In skeletonized or badly decomposed
are divided into direct, indirect, stress, or pathological. Frac- bodies, traumatic injuries of the bone may provide a major
tures resulting from direct or indirect trauma are of greatest avenue for determining the cause and manner of death. How-
interest to forensic scientists. There are many direct and indi- ever, even in fresh bodies, the direct observation of hard tissue
rect agents that can cause trauma to bone including mechani- should be conducted in all areas of suspected trauma because
cal, thermal, electrical, and others. Most of the direct trauma of the gross examination of bone can provide valuable informa-
interest to forensic scientists results in injury at the point of tion that cannot always be obtained using other tissues or
impact due to blunt, sharp, or projectile forces. The differences other visualizing methods (e.g., radiographs).

Encyclopedia of Forensic Sciences, Second Edition doi:10.1016/B978-0-12-382165-2.00015-5 1

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2 Anthropology/Odontology | Biomechanics of Bone Trauma

p0025 While the goals of trauma analysis are to determine the remodeling. Cortical bone responds differently to loads
mechanism and ultimate cause of the trauma, the first step of depending on the number and size of osteons. Due to its
trauma analysis is adequate description of the injury, its loca- structure, cortical bone is stronger along the longitudinal axis
tion, and pattern. Unfortunately, there can be considerable than along the transverse axis. Finally, the macrostructure of a
variation in the expression of injury due to the same mecha- bone is influenced by its cross-sectional shape, areas of buttres-
nism as well as similarities in injuries caused by different sing (thickening), and differential density. During life, the
mechanisms. Proper description of the injury morphology architecture and material properties of a bone adapt to meet
(i.e., size, shape, location, line of fracture propagation, seg- the functional demands it experiences.
ment relationships, and pattern) is the basis for determining
the mechanism and aids in interpreting the ultimate cause.
Interpreting the ultimate cause of the injury requires additional Material Properties of a Bone s0030

information such as the pattern of trauma in populations, the The strength of bone is generally defined as its ability to with- p0040
context of the human remains, and other sources of evidence. stand loads (force or moment) without failing. Loads can be
applied in tension (stretching), compression (compaction),
bending (angulation), torsion (twisting), shear (sliding), or a
s0020 Bone Structure and Material Properties

F
combination of these basic components. These loads cause
internal tensile, compressive, and shear stresses on the bone.

O
p0030 To lay the foundation for how fractures occur, it is important to The type of stress will vary with the direction of the force and
first have an understanding of the structure of the bone and its the orientation of the bone. Bending loads produce tensile
material properties. These principles guide the analysis of bone stress on one surface and compressive stress on the other,

O
trauma and provide a framework for interpreting the proxi- while torsion produces tension and compressive stress at an
mate cause of trauma. 45 angle to the longitudinal axis and shear force in the

R
transverse plane.
s0025 Bone Structure To understand how a bone behaves under loads, it is im- p0045

P
portant to understand the relationship between stress and
p0035 The overall strength of the bone is dependent on its material strain. Stress in its simplest definition is the intensity of load
composition, organization, and overall geometry (amount and per unit area. Stress is generally measured on a small cube of
T
overall distribution of the bone). At the most basic level, bone bone to remove the effects of geometry. Strain, on the other
is a composite material composed of an organic matrix with hand, is the amount of dimensional change or deformation in
S

embedded mineral crystals. The organic component consists of shape that occurs due to an applied stress in one plane
collagen and other noncollagen fibers, while the inorganic (Figure 1). Bone will fail when the strain becomes too great
IR

component is primarily hydroxyapatite crystals. The organic regardless of the level of stress. Strain can be either negative or
components of bone are primarily responsible for tension positive depending on the type of load applied. For example, if
properties (i.e., elasticity and toughness), while the inorganic the two ends of a cube of bone are pulled apart during tensile
F

components are responsible for compression properties (i.e., stress, the bone will undergo an increase in length (longitudi-
stiffness). In addition to collagen and hydroxyapatite, living nal strain) and a corresponding decrease in breadth (transverse
bone also contains several types of cells (i.e., osteoblasts, oste-
R

strain). In this case, there is positive strain in length and

oclasts, and osteocytes), blood vessels, nerves, and a significant negative strain in breadth. The ratio of transverse strain to the
amount of water. The water in bone increases its resistance longitudinal strain is Poisson’s ratio, which is 0.3 for bone. If
IE

to fracturing by absorbing large amounts of energy. Bone the load is applied in a manner that causes the angles of the
generally exists in woven or lamellar form. Woven bone is bone cube sides to become distorted or slide, the bone is said
unorganized and laid down quickly. It is typically found in
V

to be undergoing shear strain.

fast-growing bones or in the callus produced during fracture
repair. Lamellar bone is highly organized bone laid down in
E

layers with the orientation of the collagen fibers at different

S

angles in each layer. There are also two primary types of bone
x
based on density and porosity that have different biomechan-
x0 x
L

ical properties. Trabecular bone (also known as cancellous y0 y y

or spongy bone), commonly found in the interior of a bone
E

near the ends of long bones and in cuboidal, irregular, and

flat bones, has high porosity, low density, and is organized as
laminated struts called trabeculae. Cortical bone (also known Normal strain Shear strain
as compact bone) is the dense bone that forms the thick outer
Figure 1 Schematic illustration of normal (tension) strain and shear f0010
wall of long bones and the thin cortex of cuboidal, irregular,
strain. Strain is the fractional change in dimension of loaded material.
and flat bones. Cortical bone is composed of lamellar bone
Normal strain along the longitudinal axis is the difference between the
interspersed with osteons that allow for the incorporation of deformed length (y) and the original length (y0) divided by the original
blood vessels and bone maintenance cells. Osteons can either length ((y y0)/y0). The normal strain in the transverse axis is the
be primary osteons or secondary (Haversian systems) depend- deformed breadth (x) divided by the original breadth (x0) divided by x0.
ing on whether they are formed new or formed by the resor- Poisson’s ratio is the ratio of the transverse strain (x) to the longitudinal
ption and replacement of existing bone in a process known as strain (y).

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Anthropology/Odontology | Biomechanics of Bone Trauma 3

Ultimate Fail FP FP
YP
force ion
eg
(stress)
stic r FP
Pla

ne
Yield point

Ultimate deformation
YP

le bo
YP

Britt
(strain)

Load
n

ne
Load
ne

io

bo
eg
(stress) Area under curve = bo
cr ile

al
Slope work force to failure
ct

rm
sti
Du

No
Ela

Elastic Plastic
energy energy

Deformation Deformation
(strain)

F
Figure 3 Idealized schematic illustrating the principles of a f0020
f0015 Figure 2 Idealized schematic illustrating the principles of load–deformation curve for different bone conditions and quality.
load–deformation and stress–strain curves. The ultimate force (or stress)

O
Brittle bone is stiffer and therefore has a steeper slope but fractures with
is denoted by the height of the curve, while the ultimate deformation little or no deformation in the plastic region and requires less work for
(or strain) is denoted by the point of failure. The area under the curve failure than normal bone. Ductile bone undergoes greater deformation

O
represents the work to failure. The area between the origin and the before failing and requires greater work for failure than normal bone.
vertical line dropping from the yield point equals the amount of energy YP, yield point; FP, fracture point.
absorbed elastically. The area between the two vertical lines (yield and

R
ultimate strain) represents the amount of energy absorbed plastically.
The slope in the elastic region of the curve represents the modulus of

P
elasticity or stiffness. The yield point represents the point when bone deformed before breaking under tension. Brittle bone is more
stops behaving elastically and begins to behave plastically. resistant to compression stress, while ductile bone is more res-
istant to tensile stress. The energy absorbed by a bone per
T
volume of area is equivalent to the area under the stress–strain
p0050 To understand the relationship between stress and strain, curve and is sometimes referred to as the modulus of tough-
S

imagine a cube of bone loaded in tension until it breaks. The ness. The area under the elastic region is the amount of energy
load can be measured as a function of deformation to form a absorbed elastically, while the area under the plastic region is
IR

load–deformation curve (Figure 2). As bone is loaded, it will equivalent to the energy absorbed plastically.
begin to deform. For a while, the deformation of bone is The stress–strain curve provides a basic understanding of p0055
linearly proportional to the load placed on it. If the deforma- the intrinsic nature of how bone responds to mechanical loads,
F

tion is less than 3%, the bone will return to its original shape but it must be kept in mind that bone is a dynamic composite
once unloaded. However, as the load continues to the yield tissue that exhibits anisotropic and viscoelastic characteristics
point, the curve begins to flatten. As can be seen in Figure 2, and has a unique geometry. During life, the mechanical char-
R

less loading is required to cause increasing deformation. If the acteristics of bone must combine to meet the need for
load continues to increase, the bone will eventually reach a a stiffness and compliance while minimizing skeletal weight.
IE

point of failure and will fracture. The load–deformation curve Stiffness of bone reduces strain so it does not deform signifi-
can be mathematically converted to a strain–stress curve to cantly under load and allows muscles to function more effi-
eliminate the effects of geometry. In the linear portion, the ciently. Compliance, on the other hand, allows bone to absorb
V

stress and strain are proportional to each other. The relation- energy and deform to avoid failure during direct or indirect
ship of tensile stress to tensile strain is known as the modulus dynamic loading from a fall or blow. The anisotropic nature of
E

of elasticity or Young’s modulus, while the ratio of shear stress bone causes it to behave differently depending on the direction
S

to shear strain is known as the shear modulus. The greater the of the force. As a result, the strain on bone is not necessarily the
resistance of bone to stress (steepness of stress–strain curve same as the direction of the applied force. That is, the value of
L

slopes), the greater is its stiffness. If the bone is unloaded in the modulus in the stress–strain curve can be different depend-
the elastic region, the stress falls to zero when the strain returns ing on the orientation of the bone. The viscoelastic nature
E

to zero and the bone returns to its original shape. If the load is suggests that bone can deform like an elastic material. How-
continued and deformation reaches the yield point, slippage ever, like a viscous material, bone will continue to deform or
occurs between layers of atoms and molecules at the cement creep under constant pressure and its stiffness depends on the
lines, and the stress will return to zero but the strain will not. In rate at which the load is applied. Bone becomes more brittle
this case, the bone is behaving plastically and will remain under rapid loading. Therefore, the ultimate or fracture strain is
deformed without healing. If the load continues to increase, decreased. Also, as a result of its viscoelastic properties, bone is
the bone will eventually reach its ultimate deformation or nearly twice as resistant to failure in compression as in tension.
fracture point. Brittle bone will fracture under tension before This is why bone will normally fail under tension before com-
or slightly after reaching the yield point and normally does not pression in adults.
show any significant plastic deformation (Figure 3). Tough The actual forces required to break a living bone are fre- p0060
or ductile bone, on the other hand, will become plastically quently different from the intrinsic strength of bone material,

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4 Anthropology/Odontology | Biomechanics of Bone Trauma

and numerous other factors can affect the force required to Fracture Propagation and Fracture Types s0040
fracture a living bone. In a living person, bone is protected
from fracturing through energy-absorbing mechanisms includ- Fracture Propagation s0045

ing muscle contractions and deformation of soft tissues. When more energy is transferred to a bone than it can absorb, p0075
During a fall, for example, muscles contract and reduce the the bone will fracture because the strain will surpass the ulti-
bending of bones by lessening the tensile forces, and soft mate strain. Energy absorbed by a traumatic load builds up in
tissue will absorb much of the energy. However, if the energy- the bone and is released by forming cracks. The greater the
absorbing mechanisms that protect the bone are impaired by energy absorbed by the bone, the greater is the number of
surprise, restriction, or incapacity, bones are more likely to cracks that will form. As a result, high-energy trauma will
fracture under less force. The size and geometry of bones also cause bone to fragment, while low-energy loads will usually
affect its ability to resist fracture. The geometry of bones allows cause fracture without fragmentation. Bone is weakest in shear
them to effectively withstand normal loads while remaining followed by tension and strongest in compression. Therefore,
light. Intuitively, large bones distribute forces over a larger area fractures will normally propagate in the bone along tension
and are therefore more resistant to fracture than smaller bones and shear planes. The shear planes run at 45 angles from
of similar shape. Bones with a larger cross-sectional second compressive and tensile stresses. Fractures also follow the path
moment of inertia and polar moment of inertia are also more of least resistance. In the skull, for example, there are regions of

F
resistant to bending and torsional fracture, respectively. Bones buttressing (greater thickness) that impede horizontal bending

O
that are further from the neutral axis are more efficient at of the skull bones. Therefore, fractures are more likely to occur
resisting strain. If two bones have the same cortical thickness, between the areas of buttressing because the bone can be more
the bone with the larger diameter will have greater resistance to easily bent. Fracture lines or cracks will often be diverted

O
fracturing. toward less buttressed areas. Likewise, fractures may be termi-
nated at suture lines or preexisting cracks since the energy is

R
s0035 Effects of Age and Disease on Bone Material Properties more efficiently dissipated through these structures.

P
p0065 The age of the individual and some diseases may affect the
quality and geometry of the bone, and therefore can signifi-
Fracture Types s0050
cantly influence the fracture risk. Bone’s resistance to fracturing
T
can be influenced by any process that changes its material The type of fracture produced in bone depends on the amount p0080
composition and geometry. The ratio of inorganic and organic and location of force applied and the area of impact. Proper
S

components of bone (bone mineral density, BMD) affects description of bone injuries can provide information regarding
stiffness (Figure 3). Highly mineralized bone is stiff but also the type and direction of forces and aid in the mechanism and
IR

brittle. As a result, less energy is required to break brittle bone ultimate cause of trauma. Unfortunately there is very little
than more compliant, less mineralized bone (Figure 3). Im- standardization in the procedures or terminology for docu-
mature bone has a lower BMD than adult bone. As a result, menting bone injuries. Furthermore, most bone trauma classi-
F

immature bones have greater elasticity but less stiffness than fications are derived from the medical literature that are not
adult bones and can absorb more energy and deformation necessarily appropriate for forensic scientists. Bone fractures
before fracturing. This is why children are less likely to experi- are commonly classified based on general fracture types that
R

ence bone fractures from trauma than adults. Incomplete frac- occur in all bones, fractures that occur in specific bones, and
tures are more common in the immature skeleton because the fractures that cause soft tissue damage. Detailed descriptions of
IE

bone undergoes large deformation due to the ductile proper- fracture types for each major bones of the body can be found in
ties of the bone (Figure 3). In older adults, on the other hand, many references (see section ‘Further Reading’). The intent
the bones become more mineralized, making them stiffer and here is not to develop a standard system or provide an exhaus-
V

more brittle. As a result, the bones of older individuals are tive list, but to give a biomechanical description of some of the
stronger under compression loads, but less energy is required fracture types commonly found in the forensic literature and
E

to cause them to break under tension. In addition, the strength typical forensic cases.
S

of bone in older individuals may be reduced because of the In all cases, bone injuries should be documented men- p0085
greater number of secondary osteons, reduction of water con- tioning the bone or bones involved, specific location of injury
L

tent, and the loss of bone, especially trabeculae. Secondary on each bone, type of injury (fracture, dislocation, etc.), ap-
osteons reduce bone density and increase cement lines, while pearance of the injury, patterning of fracture lines, apparent
E

the loss of water decreases the amount of energy that can be direction of the force, length of the fractures, presence of
absorbed from trauma. deformation, evidence of the timing (antemortem, perimor-
p0070 Similar to age, pathological changes in bone can affect its tem, postmortem) of the injury, and any evidence of compli-
quality and geometry. Individuals with diseases such as osteo- cations. In addition, when possible, whether the fracture is
porosis, osteogenesis imperfecta, osteomyelitis, diabetes, open or closed, the percentage and direction of apposition
Paget’s disease, Cushing’s disease, rickets, scurvy, tumors, rheu- (amount of contact between fragments in fresh or healed inju-
matoid arthritis, and others may be at increased risk of bone ries), direction of rotation (internal or external rotation of the
fracture. Osteogenesis imperfecta, for example, reduces bone distal end), and degree and direction of angulation should be
quality and causes long bone cortices to thin. Any apparent documented.
disease affecting bone should be noted and its role in the The first major distinction in fracture type is whether p0090
observed fractures should be discussed. the break involves complete or incomplete discontinuity.

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Anthropology/Odontology | Biomechanics of Bone Trauma 5

These two classes of fractures are then subdivided based on the long axis. The angle of an oblique fracture depends on whether
type of force, pattern of cracking, degree of fracturing, and the compressive or bending force is greatest. If the compression
bone type. Incomplete fracture types are commonly described forces are greater, the fracture will be more oblique. If the
as bow injuries (the force is dissipated between the yield and bending forces are greater, the fracture will be more transverse.
failure points), torus, greenstick, toddler, vertical, and depres- Long oblique fractures, which are often difficult to differentiate
sion fractures. Complete fractures are classified based on their from spiral fractures, occur when the predominant force is
shape and location and include transverse, oblique, spiral, torsion. Oblique fractures often begin as transverse fractures
comminuted, butterfly, segmental, and epiphyseal fractures. but quickly follow the shear plane, resulting in a break with a
Cranial fractures include linear (simple linear, diastatic, and short transverse section and a longer oblique section.
stellate), crush (depressed), and penetrating. While discussions Spiral fractures occur due to torsion or twisting force that p0105
of the type of fracture are useful for understanding the mech- produces a fracture that circles or spirals around the shaft.
anism of force, the different types of fractures are not mutually When a long bone shaft is twisted, the compressive and tensile
exclusive. Linear fractures, for example, may arise from a de- stresses are at approximately a 45 angle to the shaft. Tensile
pression fracture associated with blunt trauma or from a pen- stresses produce a fracture that winds around the surface and
etrating fracture associated with gunshot projectile trauma. In breaks completely when a longitudinal fissure occurs or the
general, the type of fracture that occurs is often associated with beginning and ending edges of the crack connect. The fracture

F
the velocity and mass of the striking object and the area of the originates where the tension stress is greatest and follows the

O
impact forces. angle of rotation until the fracture ends are approximately
parallel or above one another. The direction of the twisting
s0055 General fracture types can be determined by the direction of the spiral.

O
p0095 Transverse fractures result from forces applied perpendicular to Comminuted fractures are those that result in more than p0110
the longitudinal axis of the bone, often as the result of bending two fragments, and often result from large direct or indirect

R
forces on brittle bones and bones that are not under compres- forces with high energy absorption. Indirect forces frequently
sion due to weight-bearing functions. When bent, the tensile result in a ‘T’ or ‘Y’ pattern fracture. Comminuted fractures may

P
stress is applied to the convex surface opposite the direction of also result in direct blunt force trauma or penetration from a
force and compression stress on the concave surface forming a high-velocity projectile.
neutral axis (point at which the tensile and compressive stres- Crush fractures occur due to direct force to the bone which p0115
T
ses cancel each other out) near the center of the bone shaft. results in depression (forces originating on one side) or com-
Since bone is more resistant to compression than tensile stress, pression (forces originating on two sides) fractures. Depression
S

the bone will fail on the tensile side. As the fracture propagates fractures can result in incomplete penetration of projectiles or
across the shaft toward the compression side, the cross- blunt trauma produced by an object striking the bone. The
IR

sectional area of the bone is reduced and the neutral axis shifts degree of fracturing is affected by the size of the impact area
toward the compressive side until the fracture is complete. and the velocity of the force. If the area of impact is small and
If the bone is under compressive forces as well, a transverse the velocity is great, the resulting fracture may be a penetrating
F

fracture will begin on the tensile side, but as the fracture crack injury.
moves toward the compression side, shear forces become Torus, buckling, or impact fractures are due to compression p0120
greater and the fracture will begin to travel along the shear force and occur when the ends of a long bone are driven
R

plane at approximately a 45 angle in one or both directions toward each other. The resulting fracture is an outward dis-
because bone is weaker in shear than in compression. If the placement of the cortical bone around the circumference of the
IE

fracture is propagated in both directions, it will result in a bone, usually near the end of the long bone shaft. Examples of
butterfly fracture characterized by a wedge-shaped fragment how this type of fracture occurs include fracturing of the prox-
of bone on the side opposite of the force. Whether a butterfly imal humerus when falling onto outstretched upper limbs or
V

fragment is produced probably depends on the duration and fracturing of the metacarpals when punching or striking an
magnitude of the bending and compression loads. Bending object with the fist. Because the diaphysis is composed of
E

forces may result in an incomplete transverse fracture (begin- thicker, denser cortical bone and the metaphysis is primarily
S

ning on the tensile side), called a greensick fracture, that may trabecular bone surrounded by a thin layer of cortical bone,
or may not deviate at right angles. In greenstick fractures, the compression forces are more likely to result in buckling of the
L

unfractured portion of the bone often remains permanently metaphysis than of the diaphysis. Buckling is also more likely
bent. Greenstick fractures are more common in immature to occur in immature bones than in adult bones.
E

bones that have greater compliance, but may also occur in

adult bones such as the ribs. Under high loads, crushing or Cranial fractures s0060
comminution of the bone may also occur. Avulsion fractures, Fractures of the skull can occur from direct or indirect trauma. p0125
which are usually of less forensic significance because they are Linear, crush, and penetrating fractures are common with di-
self-inflicted, also result in a transverse fracture line. However, rect trauma. As with more general fracture types, these fractures
an avulsion fracture results when a muscle tendon, ligament, or are not mutually exclusive. Under direct trauma, the skull
joint capsule is pulled creating significant tensile stress that behaves similar to a semielastic ball. The curve of the cranial
caused the bone to fracture. vault at the impact site will flatten or bend internally while the
p0100 Oblique fractures result from a combination of moderate surrounding bone will bend outward. Fracturing will occur on
bending and compressive forces or bending and torsion that the tensile side in areas of bending. Whether the fracture will
cause the bone to break diagonally (often at a 45 angle) to the begin at the impact site and radiate away or begin away from

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6 Anthropology/Odontology | Biomechanics of Bone Trauma

the impact site and radiate in both directions probably de- Odontology: Post Mortem Interval (00006); Anthropology/
pends on the elasticity of the skull, the size of the impact Odontology: Bone Pathology and Ante Mortem Trauma (00014);
area, the size and shape of the object impacting the skull, the Anthropology/Odontology: Bone Trauma (00016).
architecture of the skull at the impact area, the magnitude
of the force, and other factors. Linear fractures often occur
when the skull is struck or impacts an object of high mass.
Low-velocity direct forces often result in linear or depressed Further Reading
(crush) fractures of the cranial vault. High-energy loads with a
Berryman HE and Symes SA (1998) Recognizing gunshot and blunt cranial trauma
small impact area or pointed objects striking the skull will through fracture interpretation. In: Reichs KJ (ed.) Forensic Osteology: Advances in
result in depression or penetrating injuries. Stellate or star- the Identification of Human Remains, 2nd edn., pp. 333–352. Springfield, IL:
shaped fractures are formed by multiple linear fractures radiat- Charles C Thomas.
ing from the point of impact. If the damage is more extensive, Bilo RAC, Robben SGF, and Rijn RR (2010) Forensic Aspects of Pediatric Fractures:
Differentiating Accidental Trauma from Child Abuse. New York: Springer.
comminuted fractures may occur. Concentric fractures are Currey JD and Butler G (1975) The mechanical properties of bone tissue in children.
produced when a blunt or penetrating object causes inward Journal of Bone and Joint Surgery 57A: 810–814.
bending of the bone between radiating fractures. They gener- Elstrom JA, Virkus WW, and Pankovich A (2006) Handbook of Fractures, 3rd edn.
ally circumscribe the impact area and are roughly perpendicu- New York: McGraw-Hill.

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Galloway A (ed.) (1999) Broken Bones: Anthropological Analysis of Blunt Force
lar to the radiating fractures. As the plates of bone between
Trauma. Springfield, IL: Charles C Thomas.

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radiating fractures bend inward, tensile stress occurs on the Gurdjian S, Webster JE, and Lissner HR (1950) The mechanism of skull fracture.
external surface of the outer table and progresses like transverse Journal of Neurosurgery 7: 106–114.
fractures from the outer to the inner table. Johnson KD and Tencer AF (1994) Biomechanics in Orthopaedic Trauma: Bone

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p0130 Bullet wounds are usually characterized by internally bevel- Fracture and Fixation. London: Informa Healthcare.
Kimmerle EH and Baraybar JP (2008) Skeletal Trauma: Identification of Injuries
ing entrance and externally beveling exit fractures. The shape of Resulting from Human Rights Abuse and Armed Conflict. Boca Raton, FL:

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the wound depends on the angle at which the bullet strikes the CRC Press.
bone. Because of the high energy and velocity associated with Lovell NC (1997) Trauma analysis in paleopathology. Yearbook of Physical

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projectile force, the bone is unable to absorb the energy and Anthropology 40: 139–170.
Moraitis K and Spiliopoulou C (2006) Identification and differential diagnosis of
fractures will commonly radiate from the initial perforating
perimortem blunt force trauma in tubular long bones. Forensic Science, Medicine,
fracture. Concentric fracturing may also occur. However, unlike and Pathology 2: 221–229.
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radiating and concentric fractures caused by blunt trauma, these Pierce MC, Bertocci GE, Vogeley E, and Moreland MS (2004) Evaluating long bone
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vault due to intracranial pressure. In addition, trauma resulting and Neglect 28: 505–524.
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bone often seen in fractures occurring from blunt trauma. Charles C Thomas.
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F

See also: Anthropology/Odontology: Animal Effects on Bone Turner CH and Burr DB (1993) Basic biomechanical measurements of bone: A tutorial.
Bone 14: 595–608.
(00001); Anthropology/Odontology: History of Forensic Wieberg DAM and Wescott DJ (2008) Estimating the timing of long bone fractures:
Anthropology (00002); Anthropology/Odontology: Recovery and Correlation between the postmortem interval, bone moisture content, and blunt force
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Retrieval: Forensic Archaeology (00005); Anthropology/ trauma fracture characteristics. Journal of Forensic Sciences 53: 1028–1034.
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Non-Print Items

Abstract:
The biomechanics of bone trauma is the application of mechanical laws to describe and interpret damage that occurs to bone. It involves the
examination of both the intrinsic and extrinsic factors resulting in bone injury. Knowledge of the biomechanics of bone trauma allows forensic
scientists to use bone fractures to deduce the type and direction of loading that caused the bone to fail. The strength of the bone is its ability to
withstand loads without failing, and is dependent on its material composition, organization, and overall geometry. Loads can be applied in tension,
compression, bending, torsion, shear, or a combination of these basic components. These loads cause internal tensile, compressive, and shear
stresses on the bone. However, bone is a dynamic composite tissue that exhibits anisotropic and viscoelastic characteristics and will react differently
to loads depending on its orientation and the rate at which the force is applied. When more energy is transferred to a bone than it can absorb, the
bone will fracture. The type of fracture produced in the bone depends on the magnitude, direction, rate, and area of force applied and the structural
and material properties of the bone at and near the location of the force.

Keywords: Biomechanics; Bone; Bone injury; Brittle; Ductility; Elasticity; Forensic anthropology; Fracture; Plasticity; Stiffness; Strain;
Stress; Trauma

Author and Co-author Contact Information: Au1

Daniel J. Wescott
Department of Anthropology
Texas State University
601 University Drive
San Marcos
TX 78666
USA
Tel.: +1-573-424-9663
E-mail: [email protected]

Biographical Sketch

Daniel J. Wescott is the director of the Forensic Anthropology Center at Texas State University in San
Marcos, Texas. He received his BA and MA in anthropology at Wichita State University in 1994 and 1996,
respectively. In 2001, he earned his Ph.D. in anthropology from the University of Tennessee. He has an
active research program focusing on testing hypotheses and answering questions related to forensic anthro-
pological methods and skeletal biology, especially bone biomechanics. Wescott’s research has been dissem-
inated in leading professional journals. He has served on the editorial board of the Journal of Forensic
Sciences, and as a member of the Scientific Working Group for Forensic Anthropology.
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