Understanding Bodily Injuries from Falls and Trauma
Infanticidal Damaging
Resume of precipitation injuries: “Skin intact or little affected, very serious internal damage, consisting of skeletal fractures, soft tissue breakdown and, above all, of viscera, offering the most varied combinations.” Divided into three categories: skin lesions, skeletal, and visceral.
A) Skin Lesions
Precipitation often results in total or near-total integrity of the skin. Skin elasticity can offer great resistance to lesions. Skin lesions are usually minor, consisting of excoriations and bruises. Significant skin bruising and injuries can occur only in very high-velocity impacts, often from blunt force with wide lacerations at great heights. Wounds may include puncture wounds, cuts, or piercing injuries if the individual encounters harmful agents.
B) Skeletal Injuries
Three types of trauma are identified: precipitation on the upper extremity of the body, precipitation over the lower extremity of the body, and lateral body precipitation.
- Precipitation on the upper extremity of the body: When the head hits the ground, head injuries are predominant.
- Precipitation on the lower extremity of the body: Bone lesions of the lower extremities and pelvis prevail.
- Lateral body precipitation: This often results in many rib fractures and vertebral fractures.
C) Visceral Lesions
The most common visceral lesions are ruptures of the liver and spleen, and brain injuries. In solid organs, the impact plays an important role. The mechanism of severe nervous system damage in many cases explains instantaneous death in precipitation.
Prognosis: Due to the severe injuries it produces, precipitation often leads to death through the following mechanisms:
- Internal hemorrhage due to visceral ruptures.
- Cerebral and meningeal hemorrhage.
- Brain damage from spinal and bulbar contusion.
- Lesions from vertebral fractures.
- Traumatic shock.
Medico-Legal Problems
Postmortem Precipitation
Cadavers have been plunged from a considerable height to mask homicidal injuries. A thorough autopsy can determine the nature and probable mechanism of such injuries.
Accidents at Work
These accidents often give rise to litigation due to the existence of diseases or pathological conditions. A detailed autopsy, complemented with a blood alcohol determination, can clarify the problem.
Lesions
The nature of lesions depends largely on the variety of violence involved. 80% of traumatic facial injuries arise from traffic accidents with multiple traumas. These produce three types of injury, appearing simultaneously:
- “The first result from direct impacts and are visible on the surface.
- The latter are due to movements of the spine in areas with greater mobility and are invisible.
- The third, also invisible and due to an indirect mechanism, are due to movements of the viscera within their containers and consist of shocks and tears.”
Groups of lesions:
External Lesions
These are usually minor injuries. Extensive lacerations and penetrating injuries caused by sharp agents may be found.
Cranioencephalic Lesions
These are the most common: fractures of the skull vault and base, brain contusions and lacerations, meningeal hemorrhage (subdural and epidural), and central brain hemorrhage.
Spinal Cord Lesions
Tetraplegia and paraplegia. Dislocations and fractures in the three parts of the spine vary in intensity from simple contusion to cross-section.
Chest Lesions
Both the bony thorax and its visceral contents can be affected. Thoracic organ injuries are frequently very diverse, including lung lacerations, tears, and rupture of the heart and aorta.