Evaluation of traumatic peripheral nerve injuries in terms of Forensic Medicine

Abstract

BACKGROUND: Traumatic peripheral nerve injuries are one of the leading causes of disability in young individuals. This study aims to evaluate cases of traumatic peripheral nerve injury from a forensic medical perspective and to identify their characteristic features. METHODS: A retrospective analysis was conducted on 6,953 cases who presented to the Forensic Medicine Clinic of Gülhane Train-ing and Research Hospital between September 1, 2016 and June 31, 2023. Among these, 393 cases with traumatic peripheral nerve injuries were included in the study. The age, gender, occupation, cause of trauma, scope of the legal case, injured peripheral nerves, associated bone fractures, muscle strength and sensory loss, functional recovery status, psychiatric diagnosis, and electromyography (EMG) results of the cases were examined. All medical reports of the cases were evaluated within the scope of relevant legal regula-tions. RESULTS: This study analyzed 393 cases with ages ranging from 17 to 70 years (mean age: 28.2 years). Of these, 94.9% were security personnel. The most common causes of injury were explosive devices and firearm injuries. The most frequently damaged nerves were the peroneal, ulnar, and tibial nerves. According to EMG findings, partial axonal degeneration was detected in 82.79% of the injured nerves, while total axonal degeneration was identified in 17.21%. Injuries were most commonly observed in the elbow-forearm region. Full functional recovery was noted in 5.1% of the cases. Bone fractures, particularly in the knee-leg region, were present in 73.3% of the cases. Psychiatric disorders developed in 22.1% of the cases. Injuries were deemed permanent in 94.5% of the cases, and re-evaluation was required in 60.7% of the cases after 18 months post-injury. Permanent disability was identified in 94.9% of the cases. CONCLUSION: A detailed forensic evaluation of traumatic peripheral nerve injuries was conducted, highlighting their frequent oc-currence in military conflict zones. A meticulous assessment of symptoms resulting from these injuries is necessary. Electromyography findings are effective in evaluating nerve injuries and should be integrated with physical examinations.