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109 Int'l J. Legal Med. 1 (1996)

handle is hein.journals/injlegame109 and id is 1 raw text is: Int J Legal Med (1996) 109: 1-4 A. Du Chesne G. Fechner - B. Brinkmann The distinction between lacerations and cuts in ligaments and tendons Received: 15 August 1995 / Received in revised forn: 28 February 1996 © Springer-Verlag 1996 Abstract In contrast to skin wounds the characteristic forensic features of lesions of ligaments and tendons have rarely been investigated. However, in a suspected homi- cide the question became crucial whether an isolated dis- continuity of the posterior atlanto-occipital membrane was caused by a rupture mechanism or by a cut. In order to re- evaluate the associated criteria experimental lesions were made in ligaments and tendons and examined histologi- cally. From these experiments the following criteria could be established: Lacerations exhibit complete destruction of the tissue texture with microruptures and splitting of fi- bres in the adjacent region. Such wound edges have an ir- regular structure and fibres near the rupture site exhibit variable thicknesses due to traction. Incisions exhibit smooth wound edges with no disturbance of the tissue texture. The thickness of fibres near the rupture site is regular. These results were obtained by light microscopical examination and confirmed using electron microscopy. Under controlled experimental conditions the forces necessary to rupture tendons with a diameter of 1 mm varied between 50-70 Newton (N). In the suspected homicide, the lesion of the posterior atlanto-occipital membrane was examined visu- ally and histologically and was compared with the exper- imentally established criteria. Based on these criteria the lesion could be identified as an incision which had proba- bly been caused accidentally while severing the medulla during the first autopsy and was therefore not connected with the cause of death. Key words Tendons and ligaments Ruptures and cuts Mechanical forces - Morphology Introduction The distinction between incisions and lacerations of the skin and subcutaneous tissues is well established and problems very seldom occur (e.g. Kratter 1921; Hofmann & Haberda 1927; Mueller 1975; Polson & Gee 1973; Knight 1991). The criteria are: - cut wounds or incisions characteristically show a wedge-shaped profile, straight and smooth margins, sharp angles and lack contusion at the lower edge - lacerations (split wounds) characteristically show an irregular shape with jagged and notched margins, blunt angles and with resistant structures such as nerves and vessels bridging the lesion However Janssen (1977) pointed out that severed fibres and blood vessels can exhibit irregular surfaces caused by retraction and these discontinuities can therefore some- times resemble lacerations. In a case of suspected homicide it became increasingly important to determine the mechanisms by which a dis- continuity of the posterior atlanto-occipital membrane had been caused. Since no references existed relative to this particular question, experimental studies were also per- formed. Case report A 40-year-old woman had been found dead in her home lying on the sofa, wearing normal indoor clothing and with no signs of a disturbance. The body showed no injuries and no bruising with the exception of a narrow (0.5 cm wide) and short (5-6 cm long) hor- izontal skin abrasion mark to the right anterior neck at the larynx level with scanty haemorrhages in the underlying skin and soft tis- sue. The remaining neck circumference showed no lesion. Several petechiae were present in the skin of the face and in both conjunc- tivae. Fracture of the right cormu superius of the cartilago thyreoidea. Edema of the lung. The soft tissues of the anterior and posterior trunk and the limbs revealed no relevant bruising. After extensive histopathology and toxicology without any further relevant find- ings the experts concluded that this was an atypical form of stran- gulation. The husband was charged with murder but claimed that his wife had fallen downstairs a few hours before death and attrib- uted the cause of death to this accident. Initially this was excluded because of a lack of related findings. The husband was therefore fi- nally convicted. After persistant demands from the defence lawyers the corpse was exhumed 1 year after the incident and a second autopsy car- A. Du Chesne - G. Fechner B. Brinkmann (®) Institut fur Rechtsmedizin, Von-Esmarch-Strasse 86, D-48149 Munster, Germany

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