Sharp force injuries in “clinical” forensic medicine

Suicidal or Homicidal Sharp Force Injuries? A Review and Critical Analysis of the Heterogeneity in the Forensic Literature

“…As a consequence, a discrete number of data have not been included in the present review because they were contained in studies with imprecise descriptions. In fact, as already noted in the literature , the localization of the lesion is often described only in general terms, such as the extremities and trunk. Additionally, forensically relevant aspects are not specifically mentioned in most cases, for example, the presence of defense injuries, hesitation marks, previous suicidal attempts, and psychiatric history.…”

Study of defence injuries in homicidal deaths – An autopsy study

“…These include the frequency and localisation of defence injuries, injuries of the perpetrator and artificial injuries, especially those inflicted for the purpose of insurance fraud. 3 Defence injuries may occur when the victim raises the hands or arms for protection ('passive' defence injuries) or tries to seize the weapon or the attacker's weapon-holding hand ('active' defence injuries, defence injuries sustained on grasping the weapon). 4 Defence wounds are injuries that are caused by the victim attempting to defend themselves and are typically seen on the arms and hands.…”

Mechanical Trauma and Classification of Wounds

“…Sharp force injury accounts for 10-20% of clinical forensic examinations, and sharp force trauma is the second most common cause of injury after blunt trauma investigated in clinical forensic practice (Schmidt 2010).…”

“…The differentiation between active and passive defensive injuries should not be used too rigidly; the many possible interactions between the victim and perpetrator must be considered. In some autopsy studies, two-thirds of defensive wounds to the arms and hands were seen on the left-hand side, but this cannot be demonstrated in studies of victims who survived an attack (Schmidt 2010). Some survivors have only defensive injuries, which is most likely because the attacker primarily used a knife to threaten the victim.…”

“…If the blade protrudes to the ulnar side of the fist with the edge side facing up, the cuts will be on the flexor side of the fingers in a step-like arrangement when the fingers are extended, with decreasing depths of the cuts in the ulnar-radial direction. If tendons are severed and the tendon stumps are strongly retracted, this would suggest that the knife was held in a firm hand grip at the moment of injury (Schmidt 2010). In contrast, defensive wounds are seen on both dominant and non-dominant hands and are predominantly located on the radial side, with the little finger less frequently affected.…”