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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
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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
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.
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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
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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.
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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.
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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.
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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:
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
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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.
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.
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.
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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
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underlying tissues.
MLAs: It gives idea about following
- type of weapon used
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
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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.
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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
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.
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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
AM fracture PM fracture
Shows cellular infiltration at Absent
fractured edges accompanied
with oedema & infiltration
surrounding the adjacent
tissue.
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-absence of crepitus.
-if bone felt,they are smooth & rounded,not sharp & angular.
V) Direction of wound
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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