Early Signs of Fracture Repair in the Human Rib Cage: Implications for Forensic Casework

The decomposed body of a woman discovered beneath a collapsed structure was examined at the C.A. Pound Human Identification Laboratory. Despite a mix of rib fractures with and without indications of healing, it is most likely that all fractures occurred as a result of a single, compressive event. Signs of intramembranous, and possibly direct, fracture healing at the incomplete fractures without signs of endochondral ossification at the complete fractures suggest the individual died very shortly-but not immediately-after injury. Given the case circumstances, the findings inform immediate cause of death. This case study highlights that differential healing as a result of a single event is possible. Further, it illustrates the importance of careful examination of micro-discontinuities/cracks that can occur in association with major fractures. Fracture healing and dating data are discussed, as is the possible need for critical evaluation of the antemortem/perimortem boundary.