A fracture taking place immediately after death cannot be distinguished from one immediately before death, but if a few hours after death, the differences are easily recognised, blood is not effused round the ends of the bones unless a large vessel be torn.
In the examination of bones for fracture in the living it is the duty of the examiner to have an X-ray plate taken of the injured bone, especially if the seat of injury is in close vicinity to a joint.
Previous fractures are easily recognisable after death even when the bone does not show manifestations externally; on longitudinal section the seat of fracture is rendered evident.
Is the Wound Suicidal, Homicidal,
or Accidental?
An attempt is made to answer this question by a consideration of the wounds in reference to their position, nature, extent, and direction.
In reference to their position it has to be borne in mind that one person may wound any part of the body of another, but that to the suicide certain parts only are accessible, and they have a predilection for wounding themselves in favoured regions; the front of the body and vital parts are chosen by the suicide, while wounds on the back point to homicide. Suicidal wounds on the head are generally in front or lateral, and on the neck in front or to one side, in cutting the throat. Accidental head injuries are more often on the vertex, and when there may be no history of a fall on the occiput, wounds in this situation indicate homicide.
Suicides may choose unusual regions, such as cutting of a large vessel as the femoral artery in Scarpa‘s triangle, or by a limited incision, the carotid in the neck, the injury may be about the genitals, and the penis and scrotum have been amputated.
Accidental injuries may occur on any part of the body, but most commonly on exposed parts.
The nature and extent of the wounds does not afford much assistance; with the exception of contused wounds which are usually homicidal or accidental, any other form of wound, particularly incised or punctured wounds, may be suicidal or homicidal, and with regard to gunshot wounds, much depends upon their position and extent. As a rule, the suicide does not make several wounds, and the homicide may not only inflict several but of a greater severity than are necessary to carry out his purpose.
Suicides, especially when insane, may wound themselves severely and cause great injuries by leaping from buildings or similar high positions. In some cases suicides have inflicted several and varied wounds on their bodies.