Introduction to Injuries Dr Sanjaya Hulathduwa MBBS, MD, DLM, DMJ Path(Lond) DMJ Clin(Lond), Dip. Crim MFFLM(UK) Senior Lecturer Medico legal module 21 st batch June 2014

Injury: “any harm what ever illegally caused to a person in his body, mind, reputation or property”(medico-legal definition) Hurt: “any bodily pain, disease or infirmity” Wound/Wounding: Definition changes according to the jurisdiction. Some define a wound as a breach of skin. This definition is incomplete as contusions can not be considered as wounds according to the above.

A more medically oriented definition of a wound would be “damage to body tissues due to transmission of energy beyond a threshold level”. Energy comes in different forms such as mechanical, thermal, chemical, radiation, electrical, sonic and so on. Accordingly, the wounds may also take different forms.

Mechanical energy will be applied as sharp force or blunt force. Blunt force causes 4 major types of injuries, viz: abrasions, lacerations, contusions(bruises) and fractures. Sharp force causes two major types of injuries, viz: cuts and stabs. Injuries caused due to thermal energy are called thermal burns. These can be due to dry heat or wet heat and are termed burns and scalds respectively.

Radiation energy causes radiation burns. Chemicals such as acid and alkali cause chemical/corrosive burns.

The above mentioned types of injuries are termed as basic injuries. (abrasions, contusions, lacerations, cuts, stabs, fractures and burns) When a wound is consisted of more than one form of basic injuries, such an injury is termed a complex injury. For example, one may sustain an abraded laceration with marginal bruising and an underline fracture following a traffic accident.

It should be stressed at this point that the force and weapon are two different entities. A seemingly sharp weapon may inflict blunt force injuries as well. Force is directly associated with the mechanism of causation of injury and thus directly relevant to the type of the injury while the weapon is just the implement which delivers/generates that force.

The same weapon might inflict a sharp force as well as a blunt force or both together. For example, a blunted blade of a mammoty or an axe may inflict a sharp force as well as a blunt force, leading to a lacerated cut or a cut laceration which is an intermediate injury. Same may be true for an injury caused with a broken bottle.

Medico legal issues related to injuries  Type of the injury (abrasion, laceration, contusion, cut, stab, fracture, burn etc. or any combination there of)  Type of the force applied (blunt or sharp)  Type of the weapon and its features

 Dating of injury (time of infliction)  Amount of force applied (a very crude estimate only)  Anatomical description, direction, distance, disposition etc.  Circumstances (accidental, suicidal, homicidal)

 Identification of the perpetrator (if homicidal)  Collection of trace material (Locard’s principle)  Reconstruction of the event  Categorization of hurt

 Intention of assault  Consequences of the injury (permanent/temporary and partial/complete disability, complications, death etc.)  Matters related to financial remuneration (compensation)