Sharp Force Injuries Research Articles

Femicide in Ireland 2012–2023

IntroductionFemicide represents the dramatic end-point on a spectrum of violence against women and is an increasingly prevalent medico-legal issue. Whilst there is no definition of femicide in the Irish legal system, femicide can be understood as the gender based killing of women or girls.1 The pervasiveness of gender-based violence against women is a growing cause for concern with 2018 estimates by the World Health Organisation (WHO) revealing that 1 in 3 women have experienced Intimate Partner Violence (IPV).2 Femicide remains poorly defined and underreported worldwide due to enduring stigmatisation, shame and a lack of official statistics addressing national femicide rates. AimThe aim of this study was to explore Irish cases of femicide, quantify the prevalence of femicide in Ireland and identify any emerging trends over a 12-year-period. MethodsAll homicides referred to the Office of the State Pathologist (OSP) from 2012 to 2023 were reviewed and a total of 97 cases of femicide were ?identified and included in this study. ResultsFemicide rates increased from 1 in 5 (19 %) homicides referred to the OSP in 2012–2020 to 3 in 10 from 2021 to 2023 (29 %). Domestic femicides accounted for 74 % of cases, with 41 % of women murdered in the home they shared with their killer. 56 % of women were killed by a current or former intimate partner and 20 % by a family member. Sharp force injuries were present in 75 % of femicides associated with a history of sexual violence. These cases had the highest average number of injuries per case (n = 30) and a significantly lower average age than that of the entire cohort (19 years versus 41 years). ConclusionThe true scale of gender-based violence against women remains largely hidden due to a lack of focused official statistics and a clear definition of femicide. As populations become more diverse, and displacement secondary to environmental, or humanitarian crises becomes more common, it is essential that official data is collected in order to understand and ultimately prevent gender-based violence in this vulnerable cohort.

Effects of victim's body posture and attacker's gender on slashing attacks: a biomechanical study.

Sharp force injury has been and will remain to be a major cause of violent death; however, scientific evaluations on the impact of body posture of the victim and gender of the perpetrator on sharp force injury have been scarce. The purpose of this study was to evaluate the biomechanical characteristics found in individuals (male and female) when using a Chinese kitchen knife to slash the neck of a dummy while it was in the standing and supine positions. This work offers a solid basis for forensic identifications, criminal investigations, and court trials. A total of 12 male and 12 female college students participated in this study. Kinematic, kinetic, and surface electromyography (sEMG) data were evaluated when slashing the neck of a dummy while it was in the standing and supine positions using a Chinese kitchen knife. When slashing the neck of a standing dummy, participants showed shorter contact time (19.5%) and slower shoulder velocities (30.9%) as well as higher hip velocity (26.0%) and increased root mean square (RMS) and integral electromyography (iEMG) for the anterior deltoid (51.3% and 51.2%, respectively) compared to those while the dummy was in the supine position (all p < 0.05), regardless of gender. When slashing a dummy's neck while it was in standing and supine positions, male participants showed higher shoulder, elbow, and wrist velocities (22.6%, 22.7%, and 24.4%, respectively) and higher slashing velocity (19.8%), slashing force (24.2%), and energy (46.2%) than female participants (all p < 0.05). In addition, male participants showed shorter contact time (17.8%), and the values of RMS and iEMG of the anterior deltoid, biceps brachii, extensor carpi radialis longus, and flexor carpi ulnaris were less than those of female participants (98.9%, 47.3%, 65.6%, and 33.4% for RMS and 115.1%, 59.4%, 80.1%, and 47.8% for iEMG, respectively). There was no difference in slashing speed, slashing force, and energy when using a Chinese kitchen knife to slash the dummy's neck while it was in different body postures (standing and supine), suggesting a similar level of injury severity. However, there were significant differences in slashing action patterns between the two body postures, with longer contact time, smaller hip velocity, greater shoulder velocity, and less muscle activation level of the deltoid exertion when slashing the dummy's neck in the supine position. Gender may have a greater effect on the severity of slashing, and the gender difference may be partly related to the body weight difference. The findings from this study may provide quantitative indicators and references for analyzing the motive behind the crime, as well as for case reconstruction, and for the court's conviction and sentencing processes.

Forensic Characterisation of Complex Suicides: A Literature Review

Complex suicides refer to using two or more suicide modes. In the literature, complex suicides are distinguished into planned and unplanned. Using multiple methods is related to ensuring a fatal result or because the first method appears too painful, time-consuming, or ineffective. The review aims to provide an overview of the critical features of complex suicides in the forensic context. The review was conducted by searching online databases (PubMed Central and Scopus) up to March 2023. We identified 52 articles that met the inclusion criteria, describing 261 cases. Suicides were classified as planned in 136 cases (52.1%); 105 cases (40.2%) were defined as unplanned, while in the remaining 20 cases (7.7%), the authors did not propose any classification. In 2/261 (0.8%) cases, four modes were indicated, three modes were observed in 34/261 cases (13%), and in 224/261 (85.8%) cases the suicides were carried out using a combination of two distinct methods. The method most frequently employed in the first instance in unplanned suicides were sharp-force injuries and stabbing, followed by mechanical asphyxia (hanging, self-strangulation, plastic bag suffocation) and a fall from height. Regarding planned suicide, the most frequent suicide methods were asphyxia, intoxication (drugs, substances of abuse, or alcohol), and poisoning via toxic substances. Complex suicides represent a relatively rare entity in forensic pathology; nevertheless, they can be challenging for the forensic pathologist in terms of differential diagnosis compared to homicides, due to the sometimes multifaceted presentation.

Estimation of Pattern of Skull Fractures in Homicidal Deaths: An Autopsy Based Cross Sectional Study Conducted in a Tertiary Care Hospital

The head is the most vital part of the body among various organs as the injury to the head will result in fataloutcomes compared to injuries sustained to other parts of the body. There has been an increased global incidence of head injuries in case of homicidal deaths. The present study aims to estimate the various patterns of the skull fractures in case of homicidal deaths and also the nature of injury causing such skull fractures in homicidal deaths.The present cross-sectional study revealed that out of 4036 autopsies, there were 74 cases of homicidal deaths with 67 male and 7 female cases. The skull fracture was noticed in 54 cases out of these 74 cases. The maximum number of homicidal deaths were found to be in the age group of 21 to 40 years. Among the different types of skull fractures, the isolated cut fracture contributed to 46.30% of cases followed by isolated fissured fractures and then by the combination of other types of skull fractures. The nature of injury causing skull fractures was blunt force in 51.8% of the cases then by sharp force injuries and then by the combination of these two. To bring down the incidence of homicidal deaths among the younger individuals, strict enforcements of law may be ensued on possession of blunt and sharp force weapons which are used for the brutal attacks.

Skull fractures by glass bottles tested on cadaveric heads

Head trauma is frequently related to the misuse of drinking vessels as weapons. Forensic reports usually evaluate these blunt injuries as having occurred in scenarios where the alcohol intake is high. Fatal consequences are seen in blows with glass bottles aiming at the head. To prove the outcome that a glass bottle thrown to the head could cause, three intact human cadaver heads were impacted with 1-liter glass bottles at 9.5 m/s using a drop-tower. The impact location covered the left temporal bone, sphenoid bone, and zygomatic arch. The contact between the head and the bottle was produced at an angle of 90° with (1) the valve of the bottle, (2) the bottom of the bottle, and (3) with the head rotated 20° in the frontal plane touching again with the bottom of the bottle. The three bottles remained intact after the impact, and the injury outcomes were determined by computed tomography (CT). The alterations were highly dependent on the impact orientation. The outcome varied from no injury to severe bone fractures. In the most injurious case (#3), fractures were identified in the cranial base, sphenoid bone, and zygomatic bone. These testing conditions were selected to replicate one specific legal case, as required by the plaintiff. Physical disputes with bar glassware can lead to complex combinations of blunt and sharp-force injuries. Controlled biomechanical studies can benefit forensic analyses of violence involving glassware by providing a better understanding of the underlying injury mechanisms.

Penetrating two stab to the throat, survival time and physical mobility: a suicide case and literature review

BackgroundIt is difficult to pinpoint the manner of death in cases of death due to sharp force injuries where injury patterns resemble one another. Other issues that might arise include physical mobility and survival time after injury. Within the scope of this case, a 53-year-old male suicide with findings suggestive of homicide is presented, along with research on the nature of sharp neck injuries, survival time, and movement after injury.Case presentationThanks to the surveillance camera video that captured a significant portion of the occurrence, it was determined that the incident in the case that was presented, which had two perforations of the larynx, was suicide. At first appearance, this case could be assumed to be homicidal. Due to the injury, the victim could only walk around 300–350 m. The victim had a 4-h average survival time.ConclusionsIn general terms, the survival time according to the injury sites in the neck can be listed for a person (if the wound sizes are close to each other) as follows: injury causing vagal stimulation < arterial injury with severe blood loss < venous injury with blood loss < airway injury causing aspiration and respiratory failure.

Death by sharp force injuries of vein vessels: three different case reports

Death by sharp force injuries of vein vessels: three different case reports

Bike stunt gone wrong – Fatal Impalement by Liquor Bottle, landing into the death

Sharp force injuries are the leading cause of death worldwide. Accidental deaths due to sharp force wounds are extremely rare compared to homicide and suicide cases. Therefore, their exact incidence or prevalence is not accurately known. This paper presents an accidental death due to massive blood loss resulting from the sharp cutting of the left femoral artery by glass fragments that impaled the left groin region of a young male. He was allegedly performing a bike stunt under the influence of alcohol. The body was found in a pool of blood, surrounded by multiple glass fragments from a broken alcohol bottle that was lying shattered next to the body. The autopsy revealed a near-total transection of the left femoral artery and significant glass injuries to the skin. Evidence of self-mutilation and scarification in multiple body regions highlighted risky behavior. To determine the circumstances of death in cases of accidental glass injuries, a thorough medico legal investigation, including details of the death scene, post-mortem examination, and chemical analysis of viscera for any intoxicants or stupefying agents, is always necessary.

A TWO YEAR SHARP FORCE FATALITIES STUDY AT A TERTIARY CARE CENTRE OF CENTRAL INDIA.

The objective of this research is to study the pattern of injuries caused due to sharp edged and sharp pointed objects / weapons and to co - relate the pattern of such injuries with the manner of death. Therefore, a retrospective study was conducted at the Forensic Medicine department of government medical college and hospital, Nagpur, Maharashtra, India during the time period of January 2023 to January 2020. Post mortem examination records of 75 cases that were autopsied at the mortuary of the Forensic Medicine department of government medical college and hospital, Nagpur were thoroughly examined for studying the pattern of sharp force fatalities caused due to the impact of sharp edged and sharp pointed objects. The analysis of the autopsy reports of the 75 cases, revealed that the maximum number of deceased died due to homicide were males (54, 72%). Maximum number of deceased (28) died due to homicide with 02 to 10 sharp force injuries over their body. Maximum males (14, 18.66%) died due to single homicidal stab injury in the age group of 20 to 29 years. Maximum males (06, 18.66%) died due to a combination of incised and stab injury, in homicidal manner of death and belonged to the age group of 20 to 29 years. Maximum males (03, 18.66%) died due to a combination of all three sharp force injuries (incise, stab and chop) in homicidal manner of death and who belonged to the age group of 20 to 29 years. There exists a signicant co relation (p value 0.008318) between all the three types of manner of death (accident, suicide, and homicide) and incised injury (p value 0.008318)

Death by artery injury: two peculiar cases of sharp force fatality.

As sharp force injury accounts for 10-20% of clinical forensic examinations, forensic pathologists are often asked to investigate deceased victims of stab wounds. Moreover, homicide by sharp force (stabbing) is one of the most common in European countries, involving generally domestic or interpersonal conflict. Stabbing as a suicide method constitutes a low percentage of all suicides, 2% to 3%. Accidental death due to sharp force is even rarer (0-3%) and usu-ally caused by an impact or a fall into different type of glass surface. Death due to stabbing is usually caused by exsanguinating incisions to organs or large blood vessels (such as arteries), leading to haemor-rhagic shock. Penetrating artery injuries are well known in clinical settings, and extremities are the most common sites of such injuries. Indeed, 50% to 60% of injuries occur in femoral or popliteal arteries, 30% in brachial artery. The aim of this paper is to present two rare cases of sharp force fatality, showing how a thorough forensic pathology methodology, including death scene investigation, autopsy examination, and toxicological analyses, are pivotal to detect the manner of death. This paper presents two peculiar cases of sharp force fatalities: the first, a single and accidental stab injury on the right armpit which caused a complete transection of the axillary artery; the second, a single homicidal stab wound on the lower leg causing a full-thickness lesion of the anterior tibial artery.

Pattern of Homicide Cases in a Coastal District of Central Kerala Over the Last Ten Years: An Autopsy-Based Study

This study aims at exploring the demographical profiles of the victims and assailants, the weapons used, andthe fatal injuries inflicted on the body, in cases of homicide. A record-based cross-sectional studywas conductedat the Department of Forensic Medicine, Govt T.D. Medical College, Alappuzha, Kerala, from July 2012 to July2022. Out of 8952 autopsies conducted during the study period, there were 205 cases (2.29%) of homicide. 55.62%of cases were during the first five months, from January to May. The victims were between 31-40 years in 23.9%cases and 21.46% were 21-30 years old. Out of 205 cases of homicide, 48.36% were due to blunt force injuries and38.97% by sharp force injuries. In the case of blunt force injuries, maximum involvement was to the head &amp; face(52.55%); in sharp force injuries, involvement was highest in the chest (34.65%). The majority of the assailants weremales (73.91%). The most common alleged motive was quarrel (27.32%), closely followed by rivalry (25.85%).Thefindings of our study are mostly in agreement with the existing literature.

Weapons Related Perimortem Injuries in an Individual From the Krbava Cathedral Cemetery in Croatia - Possibly Sustained During the Battle on Krbava Field in 1493

Recent archaeological excavations of the historic period Krbava cathedral cemetery in the Lika region of Croatia revealed the presence of an individual with an antemortem fracture typical of interpersonal violence as well as a large number of perimortem sharp force injuries located in the cranial and postcranial skeleton. The cemetery is located just 500 meters south of the field of Krbava where a large battle between an Ottoman and Croatian army was fought in 1493. Archaeological evi¬dence and radiocarbon dating indicate that this individual was buried during the youngest phase of the site which dates from the first decades of the 15th until the end of the first quarter of the 16th century. The aim of this paper is to evaluate whether he may have been a soldier who perished in the battle. Osteological analysis of the skeleton shows the presence of several occupational stress markers associated with high physical activity during life, as well as numerous perimortem in¬juries that were produced by sharp objects similar to a saber. Their location in the shoulder, arm, neck, and cranial area suggests that the head was the main target of attack demonstrating the intention to incapacitate the victim as quickly as possible. Other potential hypotheses for this individual’s death, such as judicial execution, or a tavern brawl are also explored but cumulatively the collected osteological data, in conjunction with the available archaeological and historical evidence, suggest that he was a professional soldier who was killed in the battle fought on the field of Krbava in 1493.

Multiple sharp force injuries: an unplanned complex suicide or a brutal homicide?

Multiple sharp force injuries: an unplanned complex suicide or a brutal homicide?

Trauma Forensics in Blunt and Sharp Force Injuries.

Trauma forensics is the concept of examining trauma from a medicolegal standpoint in a given jurisdiction. Blunt and sharp force traumas are classified based on the different mechanisms of causation, which have a medicolegal significance. Adopting a standard approach to the medical evaluation of such injuries in patients would serve both the purposes of rendering appropriate treatment and the documentation and preservation of medical evidence. However, most trauma cases are seen by medical practitioners with very limited forensic knowledge and skills, and they are still expected to meet the needs of the court or the judicial mechanism in subsequent legal proceedings. Therefore, some measures, including 10 practical considerations, which are applicable in attending to blunt and sharp force traumas, would limit the risk a clinician faces in the crossfire of medicine and law.

Overkilling: A specific type of homicide – Constructing the definition: Injuries and victim

Overkilling in the Forensic Medicine field is known as a specific type of homicide where the number of inflicted injuries greatly surpasses the number of fatal ones. Conducted research aimed to create a unified definition of the phenomenon and its classification criteria by analysing a vast majority of data concerning its various characteristics. From the population of homicide victims autopsied in the authors’ research facility a number of 167 cases were chosen consisting of both overkilling and other homicides. 70 cases were thoroughly analysed based on the completed court files, autopsy protocols and photographs. First part of the research concerned the facts regarding the injuries sustained and the victim’s characteristics. Conclusions of the statistical analysis allowed to characterize overkilling as a type of homicide where the number of injuries (sharp or blunt) is several times higher than the number of fatal injuries. Sharp force injuries predominate, and are often localized on the torso, neck and limbs, while blunt force injuries are localized mostly on the head. There is no significant dominance between the sexes of the victims, mostly they are in their 40-50′s. Victims with reduced abilities to resist predominated (mostly women), which is correlated with the position of their body (lying or sitting) at the begging of the incident. Also overkilling victims more often suffer from defensive injuries and post mortem trauma.

Head injuries by firearms and sharp weapons in the Battle of San Martino (1859, Italy)

AbstractThe research was focused on the study of weapon‐related traumas in the skeletal remains of the soldiers who died in the Battle of San Martino (Italy, 1859). These remains are housed in the monumental ossuary of San Martino. The examination of 817 skulls revealed traces of injuries in 90 skulls, selected and submitted to anthropological studies. The aim of this work was to study the head injuries attributable to firearms and blade weapons in relation to the armaments and the military tactics used in that period.The shape, size, and features of the wounds were macroscopically examined to characterize the lesions. As regards the ballistic traumas, the caliber, the trajectory of the projectiles, and the kind of artillery were based on the diameter and localization of the entry and of the exit holes in the skulls. The sharp force traumas were identified as linear‐edge cuts or pointed lesions. The results evidenced different types of perimortem injuries, principally caused by firearms (79%) with projectiles of different calibers, mostly ranging between 14 and 18 mm. Sharp force injuries probably caused by bayonets and sabers had affected 17.8% of the skulls. The remnant 2.2% of the examined skulls presented only antemortem lesions. Moreover, seven other skulls showed healed lesions, in some cases surgically treated, testifying a rather intense war period, and the capacity of the soldiers to survive even severe injuries. The higher prevalence of gunshot wounds with respect to sharp force traumas is consistent with the military tactics and with the weapons used in that period: hand‐to‐hand combat was restricted and bayonet assault was unsuccessful compared to the use of efficient ranged weapons. This research presents important information on war‐related traumas, ballistic wounds and sharp force injuries of the armaments, and the military tactics of the mid‐19th century.

Evaluation of forensic cases presented to the pediatric emergency department.

OBJECTIVE:Child forensic cases constitute an essential part of emergency presentations. The most crucial point is that the correct planning of protective and preventive activities depends on the correct analysis of the problem; therefore, there is a need for studies on childhood forensic cases. This study aimed to obtain data on the etiological characteristics of forensic cases presented to the pediatric emergency department. We believe that the collected data will guide the social measures in preventing forensic cases.METHODS:This retrospective study consists of forensic cases aged from 1 month to 18 years and presented to the pediatric emergency service of Adana City Training and Research Hospital between January 1, 2018, and December 31, 2019. The general forensic examination report of the cases was surveyed.RESULTS:For this study, 6577 general forensic examination reports were surveyed. 40% of the patients were females, and 60% were males. Traffic accidents were the most common (35.1%) cause of the emergency presentation, which was followed by assault (16.5%), fall from height (9.2%), accidental drug-caustic corrosive substance intake (7.8%), early pregnancy (7.4%), blunt or sharp force injuries (6.3%), electrical burn injuries (5.7%), suicide (5.1%), carbon monoxide-food poisoning (2.7%), and others that consisted of work accident, firearm injury, substance ingestion, suffocation, animal attack, sudden death, and missing child (4.2%).CONCLUSIONS:This most extensive study with 6577 cases has several important implications. First of all, traffic accidents continue to be an important public health problem today. Second, cases presented to the emergency department due to assault and blunt or sharp force injuries constitute an important part of forensic cases, and children who are driven to violence and crime in childhood are a situation that requires immediate action. Our third yet most important result is that early pregnancy is a much ignored social problem despite its importance.

Clinical Forensic Assessment of Victim with Sharp Force Injury (A Case Report)

Background: Violence or trauma committed against living victims can take many different forms, including blunt force, sharp force, or other types of injury. Because sharp weapons are simple to get, violent criminal acts frequently involve them. Homicide, suicide, and accidents can all result in deaths from sharp items. Objective: This study aims to dtermine the diagnosis wound qualification on the examination on patient in the emergency room of the Bhayangkara H.S. Samsoeri Mertojoso Hospital. Methods: The method of diagnosis uses a clinical assessment and based on Criminal Code’s Criteria. Result: A 61-year-old male victim with the initials JA who claimed to have experienced sharp force injury was reported. Upon inspection of the victim, an open wound of approximately 3 cm in length, 1 cm in width, and approximately 2 cm in depth was discovered on the outside left upper arm. The patient got wound hecting and medicine to reduce the pain. After that the patient release from hospital. Conclusion: Wounds on the patient's body are criminally caused injuries that fall under the category of minor abuse, meaning they don't make the victim sick or make it difficult for them to accomplish their jobs.&#x0D;

The evaluation, management, and outcome about an experience with low velocity penetrating injuries

SFI is the abbreviation for Sharp force injuries, which is an injury inflicted by cutting or stabbing. This study evaluated 20 cases of SFIs with early diagnosis and management, including visit time, details of the demographic, wounded organs, surgical procedure, and outcomes. 20 cases of patients with penetrating injuries registered in our hospital from Apr 2015 to Nov 2016 were enrolled in the present study. The evaluation, management, and outcome of the injuries were recorded. The retrospective analysis was manipulated in terms of 20 SFIs patients admitted within 18 months. More than half of the (10) patients presented within 2 h of the injury, 8 patients within 4 h, 2 more than 6 h. All patients were in the age group of 21–30 years with no females. Knife stabbing (100%) was the mechanism of injury. Colon (50%) was the most commonly injured organ, followed by intestine injury (40%) and liver injury (30%). The mortality rate was 10%. Laparotomy was negative in two cases (10%). Wound sepsis (10%) was the common complication. All intestine and gastric injury were managed with primary repair, splenic, and kidney lesions were managed conservatively, as hollow organs required exploratory laparotomy in all cases. Early diagnosis and prompt treatment may improve outcomes for most patients.

The relationship of tumor necrosis factor alpha levels and neutrophils with skin wound age caused by sharp trauma

Background: Sharp force injuries are the second most common cause of trauma after blunt force injury. TNF- α is a cytokine that triggers the expression of adhesion molecules, other cytokines and chemokines by endothelial cells, stopped and migrated to damaged tissues or infections that trigger inflammation. Furthermore, the initial population of leukocytes leading to the wound comprises mostly neutrophils. This study aimed to assess the correlation between TNF-α levels in the blood and skin tissues and neutrophils number with the wound age of wounds caused by sharp trauma. Methods: This study is an experimental study using animal models. The samples were divided into the control group and the group in which the blood and the skin tissue samples were taken 1-, 3-, 12-, 24-, 48- and 72 hours after being sharp traumatized. The Elisa method examined the samples from the blood, and the skin of the right back of the mice was examined for TNF-α levels. Others from the left-back skin of the mice were microscopically examined to assess the number of neutrophils. Results: The TNF- α level from the skin samples were detected in wound tissue as the peak levels were in the 24 hours post-traumatic group. The TNF-α levels from blood samples indicated a significant difference in TNF-α levels in each group (p &lt; 0.05). However, TNF-α levels from skin samples showed no significant difference between each group. From the microscopic examination, there was a significant difference in the infiltration of neutrophil cells in all groups (p&lt;0,05). The neutrophils peak at 24 hours post-traumatic. Conclusion: There was no significant correlation between the TNF-α levels and the number of neutrophils with the wound age in wounds caused by sharp traumas.