Text-book of forensic medicine and toxicologyBuchanan, R. J. M. (Robert James McLean)
Science
Text-book of forensic medicine and toxicology
Buchanan, R. J. M. (Robert James McLean)
Medical jurisprudence; Poisons
_From the Third to the Fourteenth Day._--Gradual
subsidence of inflammatory action and growth of the soft
provisional callus from the periosteum and surrounding
structures, and internally in the medulla, forming a
fusiform mass holding the broken ends of the bones together
with some degree of firmness. This becomes firmer and almost
cartilaginous in density. When the bones are kept immovable,
or are impacted, the provisional callus may not be formed.
In the case of the ribs the provisional callus is always
formed, and Dupuytren‘s “ring of provisional callus” is
constant. This may also occur in fractures of the clavicle.
_From the Fourteenth Day to the Fifth
Week._--Ossification of the provisional callus. The bone
is first soft and spongy till the conversion of the soft
callus is complete.
_From the Fifth Week to some Months after the
Injury._--Complete bony union of the fracture and
absorption of the provisional callus.
Although the blood clot completely disappears from the immediate
neighbourhood of the fracture at an early period, yet layers of dark
coagulum may often be found beneath the superficial fascia for four
weeks or more after the accident (Erichsen).
It may be of importance to remember this in medico-legal inquiries.
The presence or absence of the signs of vital reaction will help to
distinguish fractures caused before or after death.
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.
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