A comparison of external and internal injuries within an autopsy series

The relationship between external injuries and internal injuries was investigated, with the aim of determining whether potentially lethal internal injuries could be reliably inferred from external findings alone. From a database of post-mortem reports, 291 were extracted and examined. The external and internal injuries were coded according to region, type and severity. Analysis of the data consisted of Spearman correlations for severity and positive predictive values for internal injuries of high lethality. Overall, the correlation between external and internal injuries was poor. The most predictive external injuries were multiple lacerations, large abrasions with lacerations, and gross distortions. Predictably, the most severe external injuries were the most reliable predictors of lethal internal injuries. External injuries of the head were more predictive of internal damage than external injuries elsewhere. Minor external injuries (such as bruises, small abrasions or small lacerations) did not predict lethal internal injuries. In conclusion, external examination findings are largely unreliable as markers of lethal internal injuries in the forensic investigation of victims of motor vehicle trauma, especially in situations where the external injuries are minor. Further research into non-invasive methods of forensic investigation is warranted.