SKELETAL TRAUMA ANALYSIS IN VIRTUAL MODALITIES: METHOD DEVELOPMENT AND APPLICATION

Abstract

Skeletal trauma analysis plays a critical role in forensic anthropology, contributing to the reconstruction of injury events, the determination of cause and manner of death, and the identification of unknown individuals. However, current approaches to blunt force trauma lack standardized, empirically validated methodologies, limiting their reliability, reproducibility, and applicability in medico-legal contexts. This study aimed to develop and evaluate a novel, standardized scoring system for blunt force skeletal trauma and to assess its potential for classifying manner of death. Using computed tomography (CT) scans from the New Mexico Decedent Image Database, trauma was scored according to a newly developed framework incorporating standardized terminology and visual criteria adapted from clinical orthopedics. Inter- and intra-observer error testing were conducted to evaluate reliability, and statistical models were applied to assess the method’s predictive utility. Results demonstrate fair to moderate interobserver agreement and substantial to near perfect intra-observer agreement, indicating that the method can be applied with a reasonable degree of consistency, particularly with increased training and access to virtual modalities. Descriptive analyses revealed patterned relationships between fracture type, skeletal element, and manner of death. However, predictive modeling produced low accuracy and poor ROC AUC values, reflecting limitations associated with small and unbalanced sample sizes. These findings suggest that while the proposed method represents a meaningful step toward the standardization and quantification of skeletal trauma analysis, its predictive application in classifying manner of death remains limited at this stage. Nonetheless, the framework provides a replicable foundation for future research and methodological refinement. By introducing standardized terminology, visual criteria, and a structured scoring approach, this study contributes to improving the rigor, transparency, and forensic applicability of skeletal trauma analysis, with broader implications for medico-legal investigations and the identification of unknown individuals.