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Sharp and

Miscellaneous
Trauma

- can be more subtle
- fracture of hyoid due to strangulation

Sharp Trauma
- narrowly focused, dynamic compression forces
- result is a discontinuity (puncture, incision, cleft)
- fracture lines, hinge fractures, and chips of bone (wastage)
also occur

Effects of Sharp Instruments
- formation of wound at point of impact
- if vertical and with cone shaped focus: puncture
- typical of instruments ending in a point
- incisions , which are longer than they are wide, occur
when forces applied across the surface of bone have
a long sharp edge
- caused by slashing or stabbing
- cleft or notch: vertically applied dynamic forces with
an instrument with a long sharp edge
- hacking with axes, machetes, etc.
- fracture lines can occur in the same fashion as before
(although hoop fractures are generally not observed)
- hinge fractures can occur and may be small or large
depending on the implement
- resultant wound can be smaller than the instrument
causing it because bone is plastic and will often
snap back after being compressed
- striations: occur on the wall of the primary injury,
run parallel to direction of applied force
- wastage: fragments separated from the main section
of bone
- commonly associated with clefts from
heavy chopping instruments
- eight attributes that can help determine causative
instrument
- cross sectional shape, width. depth, length,
striations, fracture lines, hinge fractures,
wastage
- first five occur at primary injury, remaining
three in area surrounding it
- mostly can be observed anthroposcopically
(magnification is sometimes useful)

Punctures
- pointed instrument vertical to bone surface
- indentation at point of contact, with small
sections of bone breaking inward
- generally cone shaped
- depth depends on energy
- striations may occur, fracture lines and
hinge fractures may occur with heavy force,
wastage is rare

Incisions
- sharp forces drawn across the cortical
surface of bone
- cuts can appear as mere lines
- long instruments that contact bone over a
large area will cause long incisions; short
contacting over short will cause short
incisions
- width depends in width of instrument
- generally not useful b/c of
wiggling of instrument and re-
expansion
- depth depends on energy of delivered force
and the strength of the bone
- fracture lines are rare
- wastage can occur if the incision is
particularly deep and the instrument is wide

Clefts
- vertical forces applied by heavy instruments
with long, sharp edges
- v-shaped notch
- can be accompanied by extensive fracture
lines
- striations appear vertical to the surface of
bone
- study was done that showed the differences
in clefts produced by cleavers, machetes,
and axes
- cleaver: clearly recognizable,
clean, and narrow entry sites
exhibiting no fractures, no exit site,
and fine , parallel-sided striations
- machetes: no clearly visible entry
sites, may be clean or exhibit
chattering, medium wide, with
fractures emanating from the kerf
floor, and clearly recognizable exit
sites
- Lynn and Fairgrieve study
- angle of contact could be
determined by the side where
flakes were detached
- also found that length of wounds
depended on blade width and force
- Croft and Ferllini study
- sharp trauma on ribs
- high degree of complete and
incomplete fractures
- production of wastage and bony
protrusions
- the pattern of the screwdriver head
could sometimes be discerned
- Perret study
13
- microscopic differences in hatchet
and knife
- using SEM, knife caused straight
edges, with one side exhibiting
flaking/raising; the hatchet caused
uneven and pushed back edges on
both sides
- weapons can be determined only generally and not
specifically

Wound Analysis
- description of wound, determination of
characteristics of the sharp implement, direction,
number, and sequence

Description
- note the type (puncture, incision, cleft)
- any associated fracture lines
- etc. etc.

Instrument Characteristics
- type and size
- three basic types of implements: stabbing,
cutting, chopping
- size refers to length, width, surface contour
(serrated or smooth), and sharpness
- determine the primary injury
- punctures have a point of focus
maybe w/ radiating fracture lines
- incisions are v-shaped depressions
or lines (long, thin cutting edge)
- clefts are often accompanied by
bone fragments chipped from
cortical surface
- size and placement of punctures may
indicate something
- location in, say, scapula tells you that the
instrument would need to be long enough to
penetrate a given amount of soft tissue
- width can usually not be determined
- striations indicate a serrated edge
- with incisions, just as with punctures, the
length of an instrument can be partially
determined from inaccessible areas that are
contacted and whether or not adjoining
surfaces were contacted or not
- with cleft wounds, length can generally not
be measured, but thin clefts v. wide notches
can indicate instrument width

Direction of Force
- entry wound of sharp trauma is usually
larger than the exit wound (reverse of
projectile trauma)
- although two injuries (one on front
and one on back) could be due to
separate wounding episodes

Number of Traumatic Events
- count number of separate injuries
- count points of impact
- easy with punctures and
incisions
- harder with clefts because
each impact may cause
evidence of previous blow
to chip away
- overestimation can result because a
single wound may cause 2+
wounds on the body
- decedents may also fall on
a sharp object
- recreating the action can
solve this problem
- underestimation can occur because
soft tissue wounds wont be
present

Sequence of Events
- probably cant be determined because of
large lack of fracture lines
Strangulation
- three forms: hanging, ligature, and manual
- hanging: suspended using flexible cordage
- common form of execution and suicide
- ligature: cordage of some kind is placed around the neck,
tightened, and held in place by force
- can be an accident or murder
- manual strangulation: throat squeezed by human hands until
death occurs (homicide)
- hyoid mainly sees these effects
- composed of a central body and right and left lesses
horns (cornuae) and right and left greater horns
- fracture unlikely in the young because no fusion
- general unilateral (one side) fractures
- fractures usually occur in middle and rear of greater
horns
- about 34% of deaths by strangulation show
fracturing of the hyoid bone
- be careful!
- rough postmortem treatment can break the
bone b/c of its small size
- in a substantial proportion of people, fusion
doesnt occur
- look for smooth v. jagged bone

Chemical Trauma
- numerous diseases are only evident in soft tissue
- death by slow poisoning (days and weeks) will leave
osteological markers
- can be detected through lab testing

Determining Cause and Manner of Death
- most people associate this trauma with murder, but many
people take their own lives by stabbing themselves

BOX 14.2
Death by Strangulation
- Spanish Windlass that resulted in a fracture of a bone other
than the hyoid
- female remains discovered near the 18th hole of a golf course
- perimortem fracture found to mandible, but interesting trauma
was located on vertebra
- 6th cervical vertebra displayed perimortem fractures to the
laminae (bone connecting body to neural arch)
- strong force indicated (anterior and posterior displayed
breaks)
- indicates strong force compressed the side of the
neural arch
- same force was used to compress neck
- body found with ligature around the neck composed of wire
with a wooden handle
- handle was tightened and the wire also tightened, causing the
fracture of the vertebra, but not the hyoid
- one of the few examples where FAs were able to state ligature
as the cause of death in the absence of hyoid fracture

Sharp Trauma
- the result of narrowly focused, dynamic compression forces
applied to the surface of the bone
- sharp objects require less applied force to create trauma than
do blunt objects (because it is stress that causes damage to
hard and soft tissues, and stress = force/surface area
- a number of instruments can cause these types of injuries:
- ice picks, knives, machetes, hatchets, aces

Features Associated With Sharp Force Trauma
- radiating fracture lines can occur, emanating from the point of
impact; concentric fractures are rare w/ SFT
- fracture lines may produce hinge fractures
- bone expansion followed by compression may mask the width
of the edge that caused the incision
- striations form as edges or points chatter or as irregularities
incise the bone. Striations run parallel to the direction of
applied force
- wastage refers to the loss of fragments; most common with
heavy chopping implements

Punctures
- these types of wounds are created by forces delivered by a
pointed instrument (ex. ice pick, tip of knife), usually conical
in shape
- the direction of the incision must be normal (perpendicular) or
nearly normal to the bone surface
- accompanied by small sections of bone breaking inward
(sometimes forming hinge fractures), the wound is generally
evident as an indentation at the point of contact
- striations may be evident with magnification; striations will be
perpendicular to the surface of the bone
- both fractures lines and large hinge fractures may occur;
wastage is rare

Incisions
- incisions can result from a forceful stabbing action, usually
caused by sharp forces drawn across the cortical surface of the
bone
- occasionally cuts can be so thin in cross section that they
appear only as lines, or can have a marked V-shape
- length, width, and depth of incision wound depend on a
number of factors:
- the size of the causative implement
- the amount of energy delivered
- the dimensions of the bone impacted
- depth of incision depends on force normal (perpendicular) to
the bone surface (whether in stabbing [major force normal to
bone] or incising [major force parallel to bone surface]).
- width of incision depends on blade width: however re-
expansion of bone may produce incision much narrower than
blade

Hinge Fractures
- hinge fractures are rare in cases of incision (since bone
breakage usually does not occur)

Clefts
- these marks can be caused by a vertically applied dynamic
force
- caused by heavy instruments that have a long, sharp edge
- these types of injuries usually are caused by hacking actions:
- ex. axes, meat cleavers, and machetes
- can be accompanied by extensive fracture lines radiating from
any part of the primary injury
- if enough force is applied sections may break off from the
impacted bone and result in wastage
- the depth of clefts depends on the force applied

Wastage
- wastage refers to fragments separated from the main section
of the bone
Punctures Incisions Clefts
cross-section V-shaped V-shaped V-shaped
width narrow or wide narrow or wide wide
depth shallow or
medium
shallow or deep medium or deep
length same as width short or long short or long
striations to surface || to surface to surface
fracture lines possible usu. absent possible
hinge fracture possible, usu.
small
usu. absent possible, usu.
large
wastage minimal minimal significant
- wastage can occur with all types of sharp force injuries, but
are most commonly associated with clefts from heavy
chopping instrument

Characteristics of Sharp Trauma
- eight characteristics of sharp trauma that can help to
determine attributes of the causative instrument:
- cross sectional shape
- width
- depth
- length
- striations
- fracture lines
- hinge fractures
- wastage
Instrument Characteristics
- the size of the instrument causing incisions may also be
evident from characteristics of the wound
- with punctures, blade lengths might be determined from the
placement of the wound
- the nature of striations may indicate that a blade had a serrated
(toothed) edge

Number of Traumatic Events
- the number of traumatic events (if multiple) can be estimated
by counting the number of separate primary injuries
- clefts may only indicate the minimal number of
blows causing the wounds (since subsequent blows
obliterate previous evidence)
- overestimation may result when a single blow cause
two or more lesions
- underestimation may result from blows that do not
impact hard tissue
- best to try to reconstruct sequence and nature of events

Strangulation
- strangulation takes three forms: hanging, ligature, and manual
- hanging: strangulation that occurs when the body is suspended
by its neck using flexible cordage. When done improperly (or
often in cases of suicide) strangulation rather than vertebral
fracture results
- ligature: when cordage of some kind is placed around the
neck, tightened, and held in place by force. Can occur
accidentally, but usually indicates homicide
- manual strangulation: when the throat is squeezed by human
hands until death occurs
- the hyoid bone is the main bone to manifest strangulation
- the central part of this bone ossifies before birth, and
the horns appear in the first year
- hyoid is often fractured in deaths from strangulation

Hyoid Damage During Strangulation
- fracture to greater horns of hyoid occurs in only 8% of
hangings
- fracture of greater horns occurs in only 11% of ligature
strangulations
- fracture to greater horns occurs in 34% of manual
strangulations
- absence does not rule out strangulation, but presence suggests
manual strangulation
- note, however, that greater horns must be fused to body for
damage to occur
- some 20% of adults never fuse the greater horns. By age 40
only 69% of individuals have fused the greater horns