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Medico Legal Aspect of Physical Injuries
Medico Legal Aspect of Physical Injuries
PHYSICAL INJURIES
PCPT VINCENT S BALILLA, MD
INJURY
Tangential Compression
(friction/sliding/scrape) (crushing/pressure)
ÚPostmortem Abrasions
Ú Yellowish in colour.
Ú Translucent area.
Ú Margins are sharply defined.
Ú Absence of vital reactions.
Medico-Legal Aspects
Ú Varies in sizes-Haematoma.
Ú Superficial contusions are slightly raised over the skin.
Ú May not be present at site of the impact.
Ú Superficial contusions appear soon with red colour.
Ú Deeper contusion appear late,can be detected by infra
red photography.
Ú Contusions over bony prominences are less visible
externally.
Factors modifying
the appearance of
contusion
Ú Site of injury.
Ú Vascularity of the part.
Ú Age.
Ú Sex.
Ú Colour of the skin.
Ú Nature of disease.
Ú Shifting of blood due to gravity.
Colour changes in the
contusion
Ú Colour changes in the contusion is due to
disintegration and haemolysis of red blood cells.
Ú Haemosiderin-Iron pigments,dark brown colour to
blue colour. 2-4 days.
Ú Haematoidin-Iron free pigment. Green in colour. 5-
7 days.
Ú Bilirubin-Yellow colour.7-10 days.
Ú Normal colour of skin 15-20 days.
Ú Pigments are removed by phagocytes.
Age of the contusion
Ú Colour changes.
Ú Histologically.
Ú Healing process depends on:
-Size and situation of contusion.
-Age and physique of the person.
-Presence and absence of disease.
Antemortem contusion
Ú Sharp,well defined margins.
Ú Swelling of the tissues.
Ú Discoloration of the skin.
Ú Extravasation of blood into the true skin and
subcutaneous tissue.
Ú Doubtful cases-Microscopic examination.
Postmortem contusion
Ú Can be produced with in 1-2 hrs after death.
Ú If body is decomposed it is difficult to
differentiate between antemortem and
postmortem contusions.
Self inflicted contusion
Ú Rare-can be inflicted by irritant substances
Ú Can be differentiated by chemical analysis.
Homicidal contusion
Ú Shape and size of contusion,indicates the
weapon used.
Accidental contusion
Ú Their position,arrangement,circumstances
and surroundings.
Medico-Legal Aspects
Ú Identification of the object.
Ú Degree of violence and degree of injury.
Ú Cause of injury.
Ú Time of injury.
Laceration
wounds/Injuries
Ú 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
Ú Edges are ragged,irregular and contused.
Ú Margins are abraded due to impact of blunt force.
Ú Deep tissues are crushed.
Ú Hair bulbs are crushed.
Ú Less bleeding due to crushing of underneath
vessels.
Ú Presence of foreign materials.
Ú Shape-Irregular.
Ú Size-May or may not correspond to the weapon.
Ú Margins-Irregular
Ú Floor-Tags of tissue seen across the floor.
Ú Damage to the tissue-Gross and extensive.
Ú Haemorrhage-Less because of crushing of vessels.
Ú Foreign substances at the site of injury-
dust,mud,gravels etc.
Ú Healing-Process delayed due to gross damage and
infection.
Ú Scars-Due to damage to skin and tissue.
Types of lacerated wounds
Split laceration:
Ú Direct fracture.
Ú Indirect fracture.
Direct Fracture
Focal fractures
Ú Small force applied to a small area. Injury
to overlying soft tissue is minimal.
Ú Eg-forearm and leg, where two bones lie
adjacent to each other. While defending
blows during an attack. ‘Tapping Fracture’.
Crush fractures
Ú It results from application of a large force
over a large area and is typically fragmented.
Ú Injury to the surrounding soft tissue is
usually extensive.
Ú If two bones lie adjacent to each other, both
are involved.
Ú Eg- fracture of tibia and fibula in RTA.
Penetrating fracture
Ú It results from applications of a large force
over a small area.
Ú Eg- Bullet injury to a bone. Both tissue
damage and the comminuted type of
fracture.
Indirect Fractures
Traction Fractures
Ú It results when a bone is pulled apart by
traction.
Ú Eg- Transverse patellar fracture due to
violent contraction, of this type of fracture
due to sudden contraction of quadriceps.
Angular fraction
Ú 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
Ú Fracture in spiral, when it is twisted.
Vertical compression fracture
Ú 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.
Ú In RTA there has been a collision and knee
has impacted violently against the
dashboard.
Angular-Compression fracture