Hand injuries may help reconstruct an assault. Fabricated wounds are assessed through their morphology, distribution, clothing findings and the stated history.
Hand injuries during punching
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Ragged knuckle lacerations can indicate that the fist struck the assailant's anterior teeth during a blow to an open mouth.
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Punching an assailant on the head or chin may cause fractures of the fourth and fifth metacarpals, described as knuckle fractures.
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The suspected assailant's hands may show injuries indicative of or compatible with involvement in an assault.
Definitions and motives
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Self-inflicted wounds are produced by a person on their own body. Fabricated wounds may be produced by the person themselves or by another with their consent.
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Motives include falsely accusing an enemy of assault or attempted murder, making a simple injury appear serious, pretending self-defence, or changing wounds that could connect an assailant with a crime.
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Other described motives include pretending to have defended property during collusion or theft, alleging beating by officers, escaping military service, and bringing a rape allegation against an enemy.
Types and appearance
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Fabricated wounds are mostly incised wounds. Contusions, stab wounds and burns sometimes occur; lacerated wounds are rarely fabricated.
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Fabricated incised wounds are usually superficial, multiple and parallel, with equal depth at origin and termination. They avoid vital and sensitive areas such as the eyes, lips, nose and ears.
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Described directions are behind forwards on the top of the head, above downwards on the outer upper arm, below upwards on the front of the forearms, variable on the legs, and vertical on the abdomen and chest.
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Stab wounds are usually multiple and superficial, occurring around the left arm or shoulder and sometimes on the chest. Burns are superficial and usually occur on the left upper arm.
Associated findings
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Clothes are not cut, or any cuts are incompatible with the wounds. The history of assault is also incompatible with the injuries.
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Some mentally disordered persons may inflict hundreds of small wounds on themselves. The source also describes removal of the penis, scrotum and testes in paranoid schizophrenia with strongly religious delusions.