Radiological analysis of hand and foot injuries after small aircraft crashes

Medico-legal investigation of fatal aviation accidents should contribute to the reconstruction of the accident in addition to providing the usual information about cause and manner of death. In cases with more than one fatality, the question of who was flying the plane at the time of the crash may need to be answered. In such cases the identification of "control injuries" plays an important role. This study aims to investigate whether specific patterns of skeletal hand and foot injuries could assist in the identification of the pilot. The analysis of radiological investigations of hands and feet of 27 fatalities from 18 accidents showed that foot injuries are more frequent than hand injuries in pilots and passengers, dislocations of feet were more frequent in passengers, and right-sided injuries were more frequent in pilots. Injuries of the distal parts of the hand were slightly more frequent in the pilot group. The limited numbers in the study do not allow definitive conclusions and further investigations are needed. However, the study yields interesting results and shows that radiological examination should be included in the medico-legal air crash investigation.