wound is associated with a fracture. But such a fracture is generally
transverse and sometimes comminuted. When due to an accident, such as
a fall, fracture, occurs at the weakest part of the bone, is usually spiral or
oblique and is generally not accompanied by a bruise or wound.
Distinction between Ante-znortem and Post-mortem Fractures.—Frac-
tures caused during life show the signs of effusion of blood, laceration of
muscles, pouring out of lymph, and formation of callus, but these signs are
absent in fractures produced after death. However, it is difficult to
distinguish if a fracture is caused immediately after death when the body is
still warm, though the effusion of blood about the torn muscles and fractured
ends will be very little. Besides, it should be remembered that with
ordinary force it is not possible to fracture a bone after death, as it loses its
tonicity and elasticity.
Dislocations are caused by falls, blows, or muscular action. They are
not common in old people and in those persons whose bones have become
brittle, as well as in children, in whom the separation of epiphysis is more
common. They are not dangerous unless they are between the vertebrae,
or are compound when death may result from secondary complications.
Dislocations may occur spontaneously when the joints are diseased. It
is easy to diagnose a dislocation before it is reduced. Owing to swelling,
ecchymosis and limitation in the movement of a joint it may be easy to find
it out even after it is reduced. But it is quite difficult to do so, after these
effects have passed off, unless there is paralysis or muscular atrophy due to
the involvement of a nerve as in the dislocation of a shoulder joint.
After death they may be recognized by the effusion and coagulation of
blood, and by the laceration of the soft tissues in the vicinity of the joint.
Old dislocations may be ascertained by scar tissue in and about the capsule.