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Wound  Surgically: Breach in continuity of skin or mucus membrane.

 Legally: Any lesion, external or internal, caused by violence,


with or without breach in continuity of tissue.

Injury  Legally: As per sect.44 IPC, any harm whatever illegally caused
to any person, in respect of body, mind, reputation or property.
 Injury which is associated with loss of tissue is called wound. All
wounds are injuries but all injuries are not wounds.
Trauma  An insult either physical or mental affecting one’s state of well
being.
Assault  Whoever makes any gesture, or any preparation intending or
knowing it to be likely that such gesture or preparation will
cause any person present to apprehend that he who makes that
gesture or preparation is about to use criminal force to that
person, is said to commit an assault.
Battery  Execution of assault is battery. Wounding will constitute battery
which includes even mere touch by a finger.
Hurt As per sect.319 IPC,
 Whoever causes bodily pain, disease or infirmity to any person is
said to cause hurt.
Simple hurt  Those which do not come under the category of grievous hurt &
are simple in nature & heal rapidly without leaving any
permanent deformity or disfiguration.
Grievous As per sect.320 IPC,
hurt (8  1)Emasculation: It means loss of masculine power by
clauses) -castration
-cutting of penis
-injury to testis
-injury to spinal cord at the level of L2
to L4 vertebra.
2) Permanent privation of sight of either eye.
3) Permanent privation of hearing of either ear.
4)Privation of any member or joint
Member: Any organ or limb of subject responsible for
performing distinct function.e.g.eyes,ears,nose etc
5) Destruction or permanent impairment of power of any member
or joint.
6) Permanent disfigurement of head or face.
Disfigurement: Change in configuration or personal appearance

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of subject.
7) Fracture or dislocation of bone or tooth.
8) Any hurt which endangers life or which causes sufferer to be
in severe bodily pain or unable to follow his ordinary pursuits
during the space of 20 days.
Ordinary pursuits: means day to day personal activities of
individual like attending nature’s call, taking food or bath, wearing
clothes etc
Dangerous  Is the one, which possess imminent danger to life by its direct or
injury imminent effects, because of, being extensive in nature,
involving important structure of body or organs and also being
likely to prove fatal in absence of surgical aid.
e.g. injury to internal organs or large blood vessels.
Injury likely  Is the one which constitutes great threat to life on account of its
to cause great severity & involvement of important structures of body or
death because of pre-existing conditions e.g. old age,infancy,diseased
state of health.
e.g. hypostatic pneumonia.
Injury  Is the one, which by virtue of its own direct effects can bring
sufficient to about a fatal result.
cause death e.g. injury to brain/spinal cord, injury to heart or large blood
in ordinary vessels, cumulative effects of injury, extensive burns.
course of
nature
Dangerous  Any instrument used for shooting, stabbing or cutting, or any
weapon instrument which, when used as weapon of offence, is likely to
cause death, or by means of fire or any heated substance, or by
means of any poison or any corrosive substance, or by means of
any explosive substance, or by means of any substance which it
is deleterious to human body to inhale, to swallow or to receive
into the blood, or by means of any animal.

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Medicolegal classification of injuries
On the basis of its I] Mechanical injury:
causation  Def.: Damage to any part of body d/t application of
mechanical force.
 Factors responsible for mechanical injury:
a) Force
b) Area over which it acts
c) Specific effects of the force
d) Time taken over which kinetic energy is transferred.
1)Abrasion 2)Contusion 3)Laceration 4)Incised wound
5)Puncture/stab wound 6)Fractures

II] Thermal injury

III] Chemical injury


-d/t corrosive acids/alkalies
-d/t irritants like animals, vegetable etc

IV] Firearm injury

On the basis of I]Simple injury


gravity of injury II]Serious injury
III]Grievous injury
IV]Dangerous injury
V]Fatal injury
On the basis of time I]Antemortem: recent/old
of infliction II]Postmortem

On the basis of I]Suicidal


nature of infliction II]Accidental
III]Homicidal
IV]Defence /Protective wounds
V]Fabricated /Self- inflicted wounds
Def:-These are the wounds produced on the body by oneself
(self- inflicted) or with the help of other person (fabricated) &
characterized by following i.e.
a) usually seen over the accessible parts of the body
& are superficial injuries.

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b)history of assault not compatible with the injuries.
c) If injuries made by sharp cutting weapon,then
injuries not correspond with cuts on wearing
apparels.
d)Injuries may be detected in different stages of
healing.
c) motive behind the injuries are
- to bring a false charge against enemies
- to bring a false charge of sexual offence
- to claim more compensation & draw more
attention & sympathy
-to alter the appearance of injury i.e. from simple to
grievous one
-to avoid hard duties
-to prevent linking the criminal with the crime
-to show that the injuries are the result of resisting
commission of crime

Defence wounds/Protective wounds:


 These are the wounds received by the victim in case of
assault,by the way of immediate & instinctive reaction
of self protection,by raising the arm to prevent the
attack or by grasping the weapon.
 Usually noticed over palmar aspect of hand,wrist &
inner & outer aspect of forearm.
 It depends upon:
-type of weapon used
-degree of force applied
 Absent under following circumstances:
-when attacked from back
-when asleep
-under the influence of intoxicating agent
-child /elderly persons

Abrasion
Definition  It is a type of mechanical injury characterized by destruction of
superficial layers of epithelium or mucus membrane d/t

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application of mechanical force which may be either friction
(sliding) type or pressure (compression) type.
Types Scratch:  It occurs when a body comes in contact with
(Linear) object having pointed end.
e.g.fingernail,thorn,nail,pin,tip of dagger
 The object causing scratch carry torn
epithelium in front of it.Thus, the direction
of injury is indicated by sharp edge initially
& heaped up epithelium at the end.

Graze:  It occurs when wider part of body comes in


(Brush/Scraping/ contact with rough, hard surface either body
Grinding/Sliding) grazing past or surface grazing past the
body.
e.g. vehicular traffic accidents
 It is also called as brush/friction burn
because it is caused by frictional force of
rubbing against a surface & resembles a
burn after drying.
 Here, the direction of injury is indicated by
serrated border initially & heaped up
epithelium at the end.

Pressure:  It occurs when superficial cuticles being


(Crushing/Friction) destroyed d/t sustained pressure by hard,
rough object.
e.g. ligature mark in cases of hanging &
strangulation.

Imprint:  Type of pressure abrasion where the body is


(Impact/Compact/ being pressed by rough, hard object having
Patterned) a definite shape giving the impression of
offending object.
e.g. forceful impact with a radiator grill or
cycle chain etc.

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Atypical:  It results d/t application of sustained
pressure.
e.g. teeth bite marks
Age of  Healing occurs by 2 processes:
abrasion a) Contraction of wound
b) Replacement of loss tissue

Macroscopically Microscopically

 Fresh: bright red in colour  4-6hrs: Cellular


 Within 12-24hrs: Scab/crust infiltration starts.
forms (Scab: Collection of  12 hrs: Appearance of
injured epithelium, dried fibrin network with red
blood/serum & lymph) which is cells, polymorphs &
initially reddish in colour but collagen tissue.
becomes reddish-brown in 2-3  48 hrs: Regeneration of
days. epithelium from
 4-7 days: Epithelium starts periphery.
growing from periphery to  4-5 days: Abrasion is
centre. completely covered with
 7-10 days: Scab dried, shrinks, epithelium.
separates & falls off leaving  5-7 days: Granulation
behind depigmented area which tissue is formed under
becomes normal in colour with the epithelium
passage of time.  7-9 days: Reticular fibres
appear.
 9-12 days: Collagen
fibres are detected.

MLI It gives idea about:


 Site of impact & direction of injury
(Though these are simple & superficial in nature but sometimes, it
may be external sign of serious internal injury).
 Identification of object
 Time of occurrence of injury
 Site of occurrence d/t presence of foreign body over it.
 Manner of injury can be ascertained by following:
-Abrasion in & around nose & mouth s/o smothering.

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-Cresentric nail scratch abrasion over neck s/o throttling.
-Patterned abrasion of ligature mark around neck s/o hanging or
strangulation.
-Abrasions over face, breast, genitals, inner aspect of thigh s/o
sexual assault.
-Abrasion over prepuce & glans s/o forceful sexual act or narrow
vaginal passage.
-Abrasion in & around anus s/o passive agent of sodomy.
-Multiple abrasions associated with other mechanical injuries s/o
machinery accidents, railway accidents or road traffic accidents.
-Abrasion over cornea results into corneal opacity & loss of vision
which amounts to grievous hurt.
D/Ds Postmortem abrasion  Usually results d/t rough handling of
body i.e. dragging the body after death
& are seen over bony prominences.
 No e/o colour changes & inflammatory
reaction.

Abrasions produced by  These are multiple, small, pale, dry,


animals irregular with nibbed edges.
(e.g. ant bite/rodents/  Usually seen over moist regions of
cockroaches/aquatic body such as,eyes,nose,mouth,axilla,
animals) genitals.

Nappy rash  Usually seen in infants & results d/t


excoriation of skin by excreta.
 Its position itself is explanatory.

Pressure sores  Seen in bed ridden patients & its


position itself is explanatory.

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Contusion/Bruise
Definition  Type of mechanical injury characterized by extravasation of blood
in tissue spaces due to rupture of subcutaneous & subepidermal
vessels following blunt force impact; without loss of continuity of
skin tissue.
 Effusion: Collection of fluid blood in body cavities.
Haematoma: Localised collection of blood d/t rupture of larger
blood vessels.
Eccymosis: Small sized bruises of diam.>2mm (pin head)
following minute bleeding.

Type  Intradermal bruise


 Subcutaneous bruise
 Deep bruise /Come-out bruise: manifest only after few hrs & days.
 Ectopic/Percolated/Migratory bruise: Bruise appearing at a site
remote from the site of application of force.
This is due to the blood which escapes from ruptured vessels
usually percolates through line of least resistance.Hence; it is easily
influenced by gravity.
e.g.1)Black eye/Periorbital bruise/Spectacle haematoma:
It is the extravasation of blood in & around the orbital tissue results
from:
-direct injury to orbital wall
-gravitation of blood in cases of injury over frontal region of scalp &
fracture of anterior cranial fossa.
2)Bruise behind the ear (Battle’s sign) due to:
-injury behind the ear
-fall over vertex or fracture of base of skull
3) Blow on outer aspect of thigh produce bruise around knee.
4) Blow on calf muscles produce bruise around ankle joint.
Factors Site of wound  Effusion > in lax tissue like periorbital
affecting area, face etc.
bruise < if dermis is thick like
palm, sole.
< in well yielding area such as
anterior abdominal wall.

Age  Effusion > in females d/t higher


amount of fatty tissue.

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Sex  Effusion > in children & old subjects as children
has higher amount of subcutaneous fat & in old
subjects d/t ↑sed fragility of blood vessels.
{Hence females, children & old subjects are called
ready –bruiser}.
Vascularity of  Effusion α to both.
area
Degree of
violence
Diseases  Effusion > in diseases like haemophilia,scurvy,
leukemia
Complexion of  Seen in fair skinned persons as compared to dark
individual ones.

Age of
bruise Macroscopically Microscopically Histochemical reaction
of enzyme
(As per Raekallio’s
observation)
Colour changes d/t -Infiltration of -↑sed titre of esterase
disintegration of RBCs polymorphonuclear & adenosine
by haemolysis from Hb cells (neutrophils) triphosphatase by 1hr.
& break down of Hb within 1 hr. -↑sed titre of
into certain pigments - Infiltration of aminopeptidase by
by tissue enzymes & lymphocytes by 24hrs. 2hr.
histiocytes. - Infiltration of -↑sed titre of acid
macrophages by 3 phosphatase by 4hr.
-Initially reddish in days. -↑sed titre of alkaline
colour & becomes Afterthat,appearance phosphatase by 8hr.
bluish within a day. of following: -also,↑ serotonin &
-It turns brownish d/t -reticular & elastic histamine content at
haemosiderin (iron fibres. the wound margins.
containing) pigment in -fibroblastic
next 3 days. proliferation
- It turns greenish d/t -neovascularisation
haematoidin (iron-free) -fibrinous network &
pigment in next 3 days. collagen fibres.

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-It turns yellowish d/t
bilirubin pigment in
next 2 days.
-Later on i.e. about 10-
14 days, yellow colour
slowly fades & normal
colour of skin restores
as these pigments are
removed by
phagocytosis.

{Colour changes are


absent in
subconjunctival
haemorrage d/t
diffusion of
atmospheric O2 &
subdural haematoma
d/t absence of
mesothelial lining}.

MLAs It gives idea about:


 Site of impact: except Ectopic bruise
(Though these are simple but sometimes, it may be external sign of
serious internal injury).
 Identification of object: pattern bruise caused by whip, cycle chain
while parallel bruise caused by cane.
 Time of occurrence of injury
 Degree of violence applied
 Relative position of victim & assailant.e.g.throttling
 Manner of injury can be ascertained by following
-Contusion in & around nose & mouth s/o smothering
-Contusion over neck s/o throttling
-Contusion over face,breast,genitals & inner aspect of thigh s/o sexual
assault

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Differnceces  False bruise/Artificial bruise/Simulated bruise:
-It is usually produced by juice of vegetable irritants like marking nut,
Plumbago rosea (Lal-chitra) & Plumbago zeylanica (Chitra).
Locally,
-dark brown staining of skin with absence of colour changes.
-well defined & regular margins
-presence of vesication at periphery containing serous fluid
-No e/o extravasation of blood in & around the injured tissue.
-Scrapping of the area yields positive chemical reaction
Sometimes it is accompanied with stained mark over fingertips &
other parts of body d/t scratching by affected fingers.

 Congestion:
-It results d/t stagnation of blood inside the capillaries.
-Usually it is dusky red in colour with absence of colour changes.
-C/s shows washing of blood which comes out of the capillaries.

 Postmortem lividity

 Postmortem bruise:

-Absence of swelling & colour changes


-Edges are sharply defined
-Absence of inflammatory reaction

Bruises not develop in following conditions:


 If body is covered with blanket.
 If occurs over thick part of the skin or over yielding body parts.
 If pressure is continued till death inspite of application of great
force.

Subconjunctival haemorrage:
Initially bright red in colour, then becomes yellow & finally disappears.
It results from rupture of small vessels in subconjunctival tissue d/t
 direct injury over orbital wall
 fall on vertex
 violent acts of coughing(Whooping cough),sneezing, vomiting with

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straining
 violent asphyxial deaths like suffocation, strangulation etc
 CO2 & CO poisoning

Laceration

Definition  Type of mechanical injury characterized by tear of skin or deep


tissue or both due to application of blunt force.
 Three dimensional
 Characterized by following:
-Edges are irregular, ragged & contused.
-Margins are commonly abraded & abraded area corresponds to
impacting surface.
-Bridging strands of tissue in interior of wound when examined by
magnifying lens.
-Hair follicles, if present, are crushed.
-Blood vessels are crushed resulting into minimal bleeding.
-Foreign material usually found in the wound.
Types Split laceration  Here, splitting of skin results d/t compression
(d/t blunt between weapon & underlying surface.
perpendicular e.g. laceration over head, shin of tibia etc
impact)
Stretch laceration  Here, stretching of skin at breaking point
(d/t tangential resulting in laceration at that site.
impact) e.g. laceration over fractured bone

Avulsed  Here, separation of skin from underlying


laceration/Grind tissue d/t shearing or grinding action of
laceration weight.
(d/t horizontal e.g. wheel of heavy vehicle
impact)

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Cut laceration  It results d/t cutting action of weapon which
is not very sharp.
e.g.axe,chopper

Tear laceration (d/t  Here, tearing of skin & deep tissue occurs.
impact against e.g. motor car door vehicle, blow by broken glass
irregular or blunt etc
object))
Internal laceration  d/t impact exceeding tensile strength &
elasticity of internal organ.
Others  Patterned laceration
e.g. blow by hammer over head

 Postmortem laceration:
Usually produced by animals & characterized by
-absence of vital reaction.
-edges are nibbed or gnawing.
Age  Age estimation is difficult as these injuries are often gets infected &
thus delaying the healing process.
 Healing occurs by Secondary intention & scar formation is
inevitable.
MLCs It gives idea about:
 Site of occurrence of crime ( d/t presence of foreign material)
 Identification of object (e.g. cut laceration)
 Direction of impact (d/t shelving of margins i.e. one margin
overrides the other)
 Manner can be ascertained by
-Laceration over inner aspect of lip s/o smothering
Healing by  Primary intention (Primary union):
It means healing of wound which has following characteristics
-clean & uninfected
-surgically incised
-without much loss of cells & tissue
-edges of wound are approximated by suturing

Stages:
I] Incised wound as well as sutured track on either side is filled with clot &

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there is inflammatory response from the margins.
II] Spurs of epithelial cells migrate along incised margins on either side as
well as around suture track & formation of granulation tissue begins from
below.
III] Removal of suture at around 7th day results in scar formation at the site
of incision & suture track.

 Secondary intention (Secondary union):


It means healing of wound which has following characteristics
-open with large tissue defect & infected
-having extensive loss of cells & tissue
-wound is not approximated by suturing & left open

Stages:
I] The open wound filled with blood clot & there is inflammatory response
at the junction of viable tissue.
II] Spurs of epithelial cells from the margins of the wound migrate at the
middle to cover the gap & separate the underlying viable tissue from
necrotic tissue at the surface forming scab.
III] After contraction of wound, scar smaller then the original wound is
left.

 Lacerated wound over temporal region of scalp bleed very freely


because temporal artery is firmly bound the surrounding tissue, so it
is unable to contract even when crushed.

Incised wound
Definition  Type of mechanical injury characterized by clean cut separation
of skin or deep tissue or both d/t sharp cutting edge of weapon.

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Characteristic  Three dimensional
s  Characterized by following
-Edges of wound are regular, clean cut & everted.
-Margins of wound are not contused.
{This is usually seen with use of light sharp cutting edge of weapon
while with use of heavy sharp cutting edge, edges of wound
becomes irregular, ragged & margins become contused.}
- Bleeds profusely as blood vessels are cleanly cut & not crushed.
(bleeding will be more if artery is nicked or partially cut than
completely cut d/t its inability to contract).
-Hairs, if present, are cleanly cut & not crushed.
-Sometimes, underlying bone may show superficial cuts.
-These wounds ‘gapes’ (Gaping means retraction of edges at centre)
& appears spindle shaped. Gaping will be more if made
perpendicular to ‘Line of cleavage’(Line of langer)i.e. if muscle is
cut transversally or obliquely & less if made along ‘Line of
cleavage’(Line of langer)i.e. along muscle the direction of muscle
fibres.
As a result of gaping, the width of wound is greater than the width
of weapon.
{Lines of langer:These are lines of tension determined by direction
of elastic & collagenous fibres in the dermis of skin.}
-Initially these wounds are deeper & tails off to superficial wound at
its termination.

Tailing of wound  These are superficial cuts involving only


skin seen at terminal part of incised wound
results d/t drawing of the cutting edge of
the weapon.
 Usually caused by light sharp cutting edge
of weapon.
MLAs:It gives idea about following
a) type of weapon used
b) relative position of victim & assailant if
used homicidally
c) if used suicidally, the hand used.

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Hesitation/Tentativ  These are multiple, small, superficial,
e cuts somewhat parallel, usually skin deep cuts
seen near or at the commencement of
incised wound & may merge with main
incised wound.
 Usually caused by light sharp cutting edge
of weapon.
 Commonly seen in suicidal cut throat &
suicidal cuts on wrist & not found in
homicidal assaults were defence wounds
are present over palmar aspect of hand.
MLAs: It gives idea about following
a) type of weapon used
b) hesitative state of mind at the time of
infliction

Bevelled cuts  These are the cuts caused by obliquely


impact with sharp cutting edge of weapon
(heavy), where flapping of one margin of
wound at the cost of the other present.
 Commonly seen in homicidal assaults.
MLAs: It gives idea about following
a) type of weapon used
b) direction of wound
 Accidental bevelled cuts seen over tip of
fingers during sharpening of pencil by
blade.

Chop wounds  These wounds are caused by heavy cutting


edge of weapon but not so sharp.e.g.axe
 Commonly seen in homicidal assaults over
exposed & easily accessible parts of
body.e.g head,face,neck,shoulder &
extremities Characterized by following
- Edges of wound are irregular, ragged.
- Margins of wound are often contused.
- Associated with marked destruction of

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underlying tissues.
MLAs: It gives idea about following
- type of weapon used

 Incised wounds over wrinkling areas of the body looks like


lacerated wounds (inverted edges) & are called lacerated looking
incised wound.e.g.scrotum,neck{d/t adherence of platysma &
dartos muscle to overlying skin}.
Age  Healing occurs by Primary intention.
Fresh: margins tender, covered by soft blood clots &
microscopically swelling of vascular epithelium, dilation of
capillaries & infiltration of neutrophils.
12-24hrs: Dried scab with blood clots bridging the margins &
microscopically ↑sed leucocytic infiltration.
36-48hrs: formation of capillary network.
72hrs: Development of connective tissue, granulation tissue,
fibroblast & thickening of capillary walls.
7-10days:Scar formation
MLAs It gives idea about following
- Type of weapon used.
- Direction of object.
- Time of occurrence.
- Site of wound suggest motive/intent/mental status of assailant.

Lacerated wound Incised wound


Causative agent Caused by blunt weapon or fall Caused by sharp cutting weapon.
against hard blunt surface.

Characteristics -Edges of wound are irregular, - Edges of wound are regular, clean
ragged. cut & everted.
- Margins of wound are often -Margins of wound are not
contused contused.
-Condition of underlying - Condition of underlying tissues:
tissues: a) Bleeds profusely as blood vessels
a) Bleeds less as blood vessels are cleanly cut & not crushed.
are crushed. b) Hairs, if present, are cleanly cut
b) Hairs, if present, are crushed. & not crushed.
c) Foreign material if present c) Foreign material not present.
indicates the site of occurrence

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of crime.
Wearing Clothes torn but not clean cut. Clothes are clean cut.
apparels

Suicidal cut throat Homicidal cut throat


 Usually seen over upper part  Usually seen over both sides of
of anterolateral aspect of left front & lower part of neck below
side of neck above the level the level of thyroid cartilage.
of thyroid cartilage, if person Thus, the sloping of wound is
is right handed & vice-versa. away from the floor of mouth.
Thus, the sloping of wound is
towards the floor of mouth
 It runs obliquely downwards,  The direction of wound will
forwards, medially across the depend upon the relative position
front of neck, to end over of victim & assailant. i.e. if
lower part of anterolateral attacked from right, it runs
aspect of right side of neck. transversally/obliquely from left
to right & vice-versa; if attacked
from behind, it resembles
suicidal cut throat injury.
 Main incised wound  More than one deep incised
accompanied with wound with absence of
hesitant/tentative cuts hesitant/tentative cuts.
 Defence wounds are absent  Defence wounds are present.
 No e/o signs of struggle over  Signs of struggle present &
body, clothings or place of sometimes foreign material such
occurrence. as fibre, button, hairs of the
assailant may be found in the
hand of victim.
 The weapon is firmly grasped  Usually the weapon is missing at
in the hand d/t cadaveric the scene of crime & if found it
spasm or it may be found in bears fingerprint impressions of
the vicinity of the victim & it assailant.
bears fingerprint impressions
of victim himself.
 h/o previous suicidal  Circumstantial & other e/o

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attempts, self-inflicted struggle seen at the scene of
injuries, suicidal note may be crime.
found.
 Causes of death in cut throat injury:
-Hemorrhagic shock: d/t injury to blood vessels.In suicidal variety,carotid
artery usually escapes d/t extension of neck & bleeding is usually venous
while in homicidal variety,bleding is usually from the carotid artety as it is
completely severed.
-Choking: d/t inhalation of effused blood.
-Mechanical asphyxia: d/t completely severing of trachea.
-Laryngeal oedema: within few hrs of injury.
-Vagal inhibition: d/t injury to carotid body.
-Air embolism: d/t partially severed external jugular vein & air being
sucked in the vein by negative pressure..
-Infection.
-Aphonia: d/t injury to vocal cord.

Punctured wound(Stab wound)


Definition  Type of mechanical injury characterized by piercing of skin &
deeper tissue d/t sharp pointed object.
e.g.dagger,ice pick

Characteristic  Three dimensional


s  Depth > length
 Types:

Punctured  If wound terminates in skin & underlying deeper


wound tissue.

Penetrating  If wound terminates in tissue, organ or cavity.


wound (Here, edges of wound everted d/t withdrawl of weapon).

Perforating  If wound transfix (through & through wound).


wound (Here, wound of entry: larger & edges are inverted while
wound of exit: smaller & edges are everted as the
weapon usually tapers at the tip; clothes may push inside
the wound)

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MLAs It gives idea about following:
 Type of weapon used & its dimensions:
a) From the terminal ends of wound:
-If both ends are of acute angled: wound appears elliptical shaped &
indicates the use of double edged weapon.
- If one end is acute & other blunt: wound appears wedge shaped &
indicates the use of single edged weapon.
- If both ends are of blunt: wound appears circular shaped &
indicates the use of pointed circular shaped weapon.
-If wound appears cruciate shaped: indicates the use of pointed
triangular shaped on cross section weapon.
b) From the dimensions of wound:
-Depth of wound: usually same as the length of blade of weapon.
It may be > if present over yielding parts of body (e.g. anterior
abdominal wall) & in PM wounds as compared to AM wounds d/t
loss of elasticity & development of RM.
-Length of wound: usually same as the breadth of blade of weapon.
It may be > d/t
-withdrawal of weapon
-twisting movement of victim with the
weapon
-rocking movement of weapon
-transversally cutting of muscles
-repeated stabbing through the same entry
wound
It may be < d/t contraction of elastic skin
-Breadth of wound: usually same as the thickness of blade of
weapon.
It may be > d/t gaping of wound
-Bruising around wound: indicates the weapon had been inserted up
to the hilt.
 Relative position of victim & assailant from the direction of
wound.
 Depth of wound suggests force of impact & intention of assault.
 Time of occurrence from the age of injury.

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Punctured wound Gunshot wound

Causative Pointed object Firearm (bullet/bunch of pellets)


agent
Shape Wedge/elliptical/circular/cruciat Usually oval/circular
e
Edges Clean cut Irregular, ragged
Margins Contused d/t impression of hilt Contused & show e/o
blackening,burning,singeing,scorching,
tattooing.
Tract Convergent d/t tapering tip divergent
Foreign Part of broken fragment of Part of residues of firearm e.g. unburnt
material weapon gun powder,wadding,bullet/pellet
Circumstantia absent Present (sound of firearm)
l
evidence

Concealed punctured wound:


 These are the punctured wounds made by pin or needle over
concealed parts of body such as fontanelle, inner canthus of eye,
nostrils, axilla, vagina & rectum.
 Usually seen in infanticide cases.

Harakiri:
 Unusual form of suicide in Japanese where abdomen is punctured by
short sword in sitting position resulting in sudden evisceration of
abdominal organs.

AM clot PM clot
1.  Adherent to vessel wall  Not adherent to vessel wall
2.  Firm & laminated in appearance &  Soft, brittle, jelly like & pulled
pulled out in layers. out in enmass.

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3.  Composed of fibrin, RBCs,  Composed of fibrin,RBCs.
platelets.
4.  Yellowish or grayish white  Reddish

Fracture
Definition  Break in continuity of bone.
Types Direct fracture 1)Focal fracture:
 Results from application of small force over
small area.
 Usually transverse type

2)Crush fracture:
 Results from application of large force over large
area.
 Usually comminuted type

3)Penetrating fracture:
 Results from application of large force over
small area.
e.g. bullet injury.

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Indirect 1)Traction fracture:
fracture  Results when a bone is pulled apart by traction.
e.g. transverse patellar fracture d/t sudden violent
contraction of quadriceps.

2)Angulation fracture:
 Results d/t bending of bone.

3)Rotational fracture:
 Produces spiral fracture.

4)Vertical compression fracture

Others 1) Traumatic fracture:


2) Pathological fracture: mainly from pre existing
disease & little trivial trauma.
e.g.
osteoporosis,scurvy,osteomalacia,malignancy of
bones, vitamin D deficiency or dietary deficiency
d/t low Ca intake, prolonged steroid therapy.
3) Simple fracture: fracture showing single break; it
may be -very thin (linear)
-partial (green stick fracture) usually seen
in children d/t more flexible bones than
adults.
-complete (transecting): transverse,
oblique, spiral.

Comminuted type: fracture showing multiple


Break

4)Closed fracture: if skin remains intact over fracture


site.
Compound/Open fracture: if skin remains
lacerated over fracture site.

Healing of 5 stages of healing:


fracture  Hemorrhagic phase
 Proliferative phase

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 Callus phase
 Consolidation phase
 Remodelling phase

Histologically:
 Signs of clot formation: within 2 days.
 Formation of osteoid matrix within 3 days & its transformation
into soft callus within 1 wk.
(Soft callus: d/t osteogenic granulation tissue between fractured
ends & it becomes visible on X-ray after 3 wks).
 The gap between fractured ends is filled with callus within 1 mth.
& within 6wks-2mths, it is transformed into bone (hard callus).
 Remodelling & reabsorption of excess callus takes about 6mths.
At this stage, approximate age can be estimated from:
-the extent of remodelling
-smoothness of edges
-running of trabeculae across the line of fracture

MLAs  Grievous hurt


 Site indicates cause of death.
e.g. throttling, fracture of long bones causing release of fatty
material from bone marrow causing fat embolism & here,
diagnosis done by frozen section of tissues stained for fat with
Sudan III, Osmic acid.
Fracture of tibia & fibula: loss of 500ml-1ltr of blood
Fracture of femur: loss of 2 ltr blood.
 Time of occurrence from the stage of healing

AM fracture PM fracture
 Shows cellular infiltration at  Absent
fractured edges accompanied
with oedema & infiltration
surrounding the adjacent
tissue.

Dislocation differentiate from fracture by following:


-lies in the vicinity of joint.
-there is restricted mobility instead of abnormal mobility.

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-absence of crepitus.
-if bone felt,they are smooth & rounded,not sharp & angular.

Medicolegal aspects of wounds:


I) General facts:
 Motive
 Suicidal note
 Place of occurrence
 Scene of crime
 Clothings
 Place where the weapon is found
 Nature of weapon
 Multiplicity of injuries

II) Situation of wound

III) Number of wounds

IV) Nature & extent of wounds

V) Direction of wound

VI) Position of the body with relation of injuries

VII) Evidence derived from the surroundings


 From examination of accused
 Trace evidences

Medicolegal significance of AM & PM wounds:


 Fabrication of false evidence
 Avoidance of punishment
 Concealment of crime

Volitional acts:
 The acts which are possible for the deceased after receipt of fatal
injury. i.e. running, shouting, climbing up stairs etc.

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