Clinically its defined as solution or
disruption of the anatomical
continuity of any tissues of the body.
Article 262 Mutilation
Article 263 Slight Physical Injuries
Article 264 Administering Injurious
Substances or Beverages
Article 265 Less Serious Physical
Injuries
Article 266 Slight Physical Injuries and
Maltreatment
Wound
Medico-legally include any
lesion,external or internal,caused
by violence,with or without breach
of continuity of skin.
Are those,which are caused by the
physical violence to the
body,depending on the manner
and how they are caused.
Examples:- Blunt force injury.
Sharp force injury.
Fire-arm injury.
Classification of Mechanical
Injuries
Blunt Force Injuries/Trauma:
Abrasions.
Contusions,.
Lacerations.
Sharp Force Injuries/Trauma:
Incised wounds.
Stab wounds.
Chop wounds.
Fractures.
Fire arm injuries.
Abrasions
Injuries involving superficial layers of the
skin and are caused by
-Impact of an object.
-Fall on rough surface.
-Pressure of finger
nails,teeth,muzzle of
a gun or by rope.
Abrasion
Tangential
Compression
(friction/sliding/scrape)
(crushing/pressure)
Linear
Patterned
(scratch)
Brush
Patterned
(graze)
Impact
Non-
Contact
Age of abrasion
Recent abrasion appears bright red scab
12-24 hrs.
Reddish brown scab 2-4 days.
Healing process starts 4-7 days.
Epithelium grows and dried scab falls 810 days.
Absence of infection.
Antemortem
Abrasions
Reddish brown colour.
Margins are blurred due to vital reactions.
Postmortem
Abrasions
Yellowish in colour.
Translucent area.
Margins are sharply defined.
Absence of vital reactions.
Artifacts in
Abrasion
By
By
By
By
Ants.
Insects.
Animals.
Marine animals.
Medico-Legal
Aspects
Site of impact and possibility of internal
injury.
Identification of object causing the
injury.
Cause of injury.
Direction of injury.
Time of injury.
Contusion/Bruise
Contusion is an infiltration or
extravasion of blood into the tissue
due to rupture of vessels by the
application of blunt force.
Examples:-Stick,stone or fist.
Its subcutaneous without
discontinuity of skin.
Features of
contusion
Varies in sizes-Haematoma.
Superficial contusions are slightly raised
over the skin.
May not be present at site of the impact.
Superficial contusions appear soon with
red colour.
Deeper contusion appear late,can be
detected by infra red photography.
Contusions over bony prominences are
less visible externally.
Factors modifying the
appearance of
contusion
Site of injury.
Vascularity of the part.
Age.
Sex.
Colour of the skin.
Nature of disease.
Shifting of blood due to gravity.
Colour changes in the
contusion
Colour changes in the contusion is due to
disintegration and haemolysis of red blood
cells.
Haemosiderin-Iron pigments,dark brown
colour to blue colour. 2-4 days.
Haematoidin-Iron free pigment. Green in
colour. 5-7 days.
Bilirubin-Yellow colour.7-10 days.
Normal colour of skin 15-20 days.
Pigments are removed by phagocytes.
Age of the
contusion
Colour changes.
Histologically.
Healing process depends on:
-Size and situation of contusion.
-Age and physique of the person.
-Presence and absence of
disease.
Antemortem
contusion
Sharp,well defined margins.
Swelling of the tissues.
Discoloration of the skin.
Extravasation of blood into the true skin
and subcutaneous tissue.
Doubtful cases-Microscopic examination.
Postmortem
contusion
Can be produced with in 1-2 hrs
after death.
If body is decomposed it is difficult
to differentiate between
antemortem and postmortem
contusions.
Self inflicted
contusion
Rare-can be inflicted by irritant
substances like Marking nut,root of
plumbago zeyloxica or rosea.
Can be differentiated by chemical
analysis.
Homicidal
contusion
Shape and size of contusion,indicates
the weapon used.
Accidental
contusion
Their
position,arrangement,circumstances
and surroundings.
Medico-Legal
Aspects
Identification of the object.
Degree of violence.
Cause of injury.
Time of injury.
Laceration
wounds/Injuries
These are the wounds caused by
the blunt force resulting torn of the
skin and the underlying tissue,with
a minimal bleeding.
Features of the lacerated
wounds
Edges are ragged,irregular and contused.
Margins are abraded due to impact of blunt
force.
Deep tissues are crushed.
Hair bulbs are crushed.
Less bleeding due to crushing of
underneath vessels.
Presence of foreign materials.
Shape-Irregular.
Size-May or may not correspond to the
weapon.
Margins-Irregular
Floor-Tags of tissue seen across the floor.
Damage to the tissue-Gross and
extensive.
Haemorrhage-Less because of crushing
of vessels.
Foreign substances at the site of injurydust,mud,gravels etc.
Healing-Process delayed due to gross
damage and infection.
Scars-Due to damage to skin and tissue.
Types of lacerated
wounds
Split laceration:
Found in pats overlying bonesscalp,face,hands and lower limbs.
Due to perpendicular impact by blunt
force.
Due to crushing of skin between two
hard objects.
It simulates the incised wound.
Stretch laceration:
Due to over stretching of skin and
produces flap.
Due to blunt tangential impact-when
head strikes on the wind screen of
the vehicle.
Due to sudden deformity of bones
after fractures.
Avulsion wound:
Degloving of skin over the
impacted area due to compression
and grinding of underlying tissue.
Commonly seen in road traffic
accidents and by machinery in
heavy industries.
Tears laceration:
Due to friction with irregular or
pointed end of a weapon or an
object on the surface of the body.
Deeper at the string point than at
the terminal.
Cut laceration:
This type of lacerated wound is
produce by not so sharp edge of
heavy weapon.
Seen in chop wounds.
Margins are not clear cut.
Abrasions or contusions are seen on
the margins.
Medico-Legal
importance
Homicidal-occurs in any part of
the body.produced by blows with
hard and blunt weapon.
Suicidal-Very rare.
Accidental-Road traffic accidents,
accidental fall from height.
Foreign bodies-Mud,gravel,oil etc.
Incised wounds
Its produced by sharp cutting instrumentsknife,razor,blade,swords,chopper,axe etc.
Features:
Edges are regular,clear cut, retracted and
averted.
Except in neck and scrotum-edges are
inverted.
Spindle shaped wound,maximum widening
in the central part.
Length is greater than the breadth.
Breadth is greater than the thickness of
the cutting blade.
Gaping is greater if underlying muscles
are divided across or cut obliquely.
Haemorrhage is excessive due to the
cleat division of blood vessels.
Half severed artery bleeds more as
they can neither retract nor contract.
Edges of wound may be irregular when
skin is loose and if cutting edge is
blunt.
By nature of the incised
wound,weapon used can be identified.
Light sharp cutting weapons-razor
blades,knife an produce incised
wounds by striking,drawing or by
sawing.
Drawing cuts-Deeper at start,gradually
become shallow and at the end only
skin is cut with scratch Tailing of the
wound
The position of the accused and victim
can be identified in homicidal
cases,and suicidal cases which hand
has been used.
Sawing cuts-Multiple at the
beginning and only one deep cut
wound called Tentative or
Hesitation cuts
Bevelling cuts-When weapon is used
oblique or tangential way over the
body.
Heavy sharp cutting weapons-like
swords,axes,choppers etc-wounds
are greater and severe. Usually
homicidal in nature.
Injuries caused by these weapons
show signs of bruising over the
edges and extensive damage to
deeper structures and organs.
Incised wounds made by curved
weapons like sickle, tangi etc will
cause single wound when hit over
the convex portion of body.
Weapons applied over the flat
surface, it will make two wounds
with intact of skin between these
two wounds and they will be in the
same line.
Medico-Legal
importance
Homicidal-Any part of the body, commonly on
the neck, head and trunk, also be found on the
inner side of forearm or hand of victim while
defending or protecting. Defence Wounds.
Suicidal-Found in the accessible parts by light
weapons on the throat (cut throat wounds). Tail
end of the wound indicates which hand has
been used.
Accidental-Any part of the body hands,
fingers during the handling of knife, razor
blades etc.
Weapon
Incised wound means use of sharp
cutting weapons.
Bevelled cuts and chop wounds
suggest use of heavy or
moderately heavy sharp cutting
weapons.
Manner of use of
weapon
Deep chop wounds and bevelling
suggests striking by the weapon.
Tailing and hesitation cuts indicate
drawing of the weapon.
Multiple superimposed or
overlapping injuries are indicated by
saw like movement of the weapon.
Direction of application of
force
From the tailing and bevelling, the
direction of application of force can
be known.
The relative position of the victim and
the assailant can also be known, by
the direction of application of force.
Age of the wound or time
since injury
In case of dead bodies-histological
examination of tissue from the margin
of the wound, gives the clue that the
survival of time after injury.
Time since injury can be studied by the
healing process.
When fresh- Bleeding is still present or
fresh soft clot is adhered, margins are red,
swollen and tender.
By 12 hrs- Blood clot and lymph dry up,
margins are red and swollen. Histologically
there is infiltration of leucocytes.
By 24 hrs- Proliferation of connective
tissue cells and vascular endothelium for
neo-vascularisation.
By 36 hrs- Fibroblastic infiltration and
capillary network formation starts.
By 48hrs- Capillary network is completed.
Fibroblasts run across the new vessels.
By 3-5days- Vessels are obliterated and
thickened, wound heals and scar formation
starts and advances.
By 6th day- Scar formation is completed.
Scab over the wound falls off. After weeks
and months, soft, tender, reddish scar
becomes tenderless, whitish and firm.
Defence wounds
Defence wounds result from the immediate
and instinctive reaction of the victim to save
himself, either by raising the arm to prevent
the attack or by grasping the weapon.
If the weapon is blunt, bruises and abrasions
produced on the forearms or backs of the
hand.
If the weapon is sharp the injuries will
depend upon the type of attack, whether
stabbing or slashing.
If the weapon is single edged and graspedsingle wound. Double edged-double wound.
Fabricated & Selfinflicted wounds
They are the wounds inflicted by a
person on his own body.
Fabricated wounds-produced by a person
on his own body or others body with
consent. (fictitious, forged or invented)
To charge an enemy with assault or
attempted murder.
To aggravate a simple injury.
By the assailant to pretend self
defence.
In thefts\robbery where servants of
the house are involved, to get
absolved from the crime.
By woman to bring a charge of
rape against an enemy.
Stab wound\Punctured
wound
These are the deep wounds produced by the
pointed end of a weapon or an object,
entering the body.
These injuries generally caused by sharp
pointed piercing stabbing weapons-knives,
dagger, bayonet, arrow, pick-axe, broken
glass pieces.
A stab wound caused by a sharp pointed and
cutting instrument has clean cut edges, have
sharp angles at the two extremities.
The wound is wedge shaped if it is produced
by instrument with only one cutting edge.
A sharp pointed and cylindrical or
conical instrument produces a wound
having a circular or slit like opening.
When the edges of the weapon are
sharp, the wound produced is an
Incised penetrating wound.
When the weapon edge is blunt, it
produces a Lacerated penetrating
wound.
When a stab wound enters into a
body cavity-thoracic, abdominal,
joint cavities penetrating
wound.
When the wound pierces the body
through and through it is known as
perforating wound.
Features of punctured
wound
Length of the external wound should
correspond with the breadth of the blade of
the weapon.
Entry wound length is little shorter than
breadth of the blade or body of the weapon.
Exit wound also similar to entry wound.
Breadth of the entry or exit wound should
correspond with the thickness of the part of
the blade of the weapon. But it depends on
the elasticity of the skin, direction of
underlying muscle fibres and their
intactness.
If the fibres are not cut, due to rigor
mortis reduces the breadth-fibres
are cut increases the breadth.
Depth is the greatest dimension of
a stab wound produced by the
length of the weapon introduced
and its length and breadth by the
breadth and thickness of the
weapon respectively.
Sometimes wound may be greater
than the length of weapon in the
yielding parts.
Edges are retracted, clean or
lacerated and bruised according to
the weapon used.
Knives, daggers, bayonets and
other sharp cutting weapons cause
surface injuries will be an Incised
Wound.
Pick-axe or horn of animals which
have blunt edges-margins
irregular, bruised and lacerated.
Shape of the wound of entrance in
case of stab wound depends on
the shape of the weapon and its
edges.
Hilt marks are common when the
weapon is pushed till the handle.
Haemorrhage is more internally
than external wound.
Injury to the vital organs are
common in stab wounds.
Concealed Punctured
Wound
These are punctured wounds
produced by needles, nails or pins.
Concealed parts of the bodynostrils, frontanella, fornix of the
upper eyelids, axilla, vagina,
rectum and nape of the neck.
Complications
Marked internal haemorrhage.
Infection to the wound due to
foreign materials.
Air embolism.
Pneumothorax.
Asphyxia due to inhalation of
blood.
Medico-Legal
Importance
Shape of wound indicates the type of
weapon.
The depth of the wound indicates the force
of the penetration.
Direction and dimensions of the wound
indicate the positions of assailant and victim.
Age of the injury can be determined.
Position, number and direction of wounds
can give clue for manner of productionSuicidal, Accidental, Homicidal.
Fracture
Fracture of a bone is defined as
disintegration or breakage of bone
due to blunt force either directly or
indirectly.
Direct fracture.
Indirect fracture.
Direct Fracture
Focal fractures
Small force applied to a small area.
Injury to overlying soft tissue is
minimal.
Eg-forearm and leg, where two
bones lie adjacent to each other.
While defending blows during an
attack. Tapping Fracture.
Crush fractures
It results from application of a
large force over a large area and is
typically fragmented.
Injury to the surrounding soft
tissue is usually extensive.
If two bones lie adjacent to each
other, both are involved.
Eg- fracture of tibia and fibula in
RTA.
Penetrating fracture
It results from applications of a
large force over a small area.
Eg- Bullet injury to a bone. Both
tissue damage and the
comminuted type of fracture.
Indirect Fractures
Traction Fractures
It results when a bone is pulled
apart by traction.
Eg- Transverse patellar fracture
due to violent contraction, of this
type of fracture due to sudden
contraction of quadriceps.
Angular fraction
It occurs due to bending of bone.
The concave surface of the bend is
compressed, while the convex
surface is put under traction
resulting in breakage.
Rotational fracture
Fracture in spiral, when it is
twisted.
Vertical compression
fracture
In this type fracture can be seen in
long bones with oblique fracture
when hard shaft of the bone is
driven into the cellous portion.
In RTA there has been a collision
and knee has impacted violently
against the dashboard.
Angular-Compression
fracture
Here the fracture line is curved,
with an oblique component due to
compression and a transverse
component due to angulation.
Repair and healing of
the fracture
Healing of the fracture depends on the age
and nutritional status of a person. Usually
cancellous bone unites faster than cortical
bone.
Haemorrhage phase.
Proliferation phase.
Callus phase.
Consolidation phase.
Remodeling phase.
In the Haemorrhagic phase,
bleeding will be at the site of fracture.
In the Proliferation phase, a collar is
formed around the fractured ends by
proliferation of cells from periosteum
and endosteum.
In the Callus phase, cellular
elements give rise to osteoblasts and
chondroblasts which produce a matrix
of collagen and polysaccharide,
impregnated with calcium.
In the Consolidation phase the
callus is transformed into mature
bone by 4-6weeks in children and
in adults by 12-14weeks.
In the final, the Remodeling
phase, matured bone will take
place.
Medico-Legal
Importance
Fracture of a bone constitutes
grievous injury according to law.
The type of fracture can give the
clue of causative force, whether
direct, indirect, rotational or angular
etc.
The site of fracture may help to
indicate the cause of death.
Eg- fracture of hyoid bone
suggestive of throttling.
Dr. Ajee Kuruvilla
