AN AUTOPSY BASED STUDY OF PATTERN OF INJURIES IN PERSONS WITH HISTORY OF FALL FROM TRAIN AND JUMPING IN FRONT OF RUNNING TRAIN.

Corresponding Author:
Sreelekshmi J,
Junior Resident,
Department of Forensic Medicine,
Government T. D. Medical College, Alappuzha.
E-mail: jsreelekshmij@gmail.com

ABSTRACT

BACKGROUND

Large scale disruption of different body parts is seen in fatal railway incidents whether accidental or suicidal. Careful examination of body parts is necessary to find the relative position of victim and train during the occurrence of incident. Extensive mutilation of the body makes identification difficult and the relatives often refuse to believe that their family member committed suicide. An attempt is made to study the pattern of injuries that occur during accidental fall from train and suicidal jumping in front of the train, so that it may help a forensic pathologist to suggest a possible manner of death when sufficient history is not available.

MATERIALS AND METHODS

A descriptive study of all railway track deaths brought for medicolegal autopsy at Thiruvananthapuram Medical College, Kerala, from 1^st March 2010 to 28^th February 2011 were analysed. A total of 104 cases of railway track deaths were studied excluding cases with advanced decomposition. Data regarding nature of incidents were collected from the Kerala Police Form 102 (KPF 102), investigating officers and relatives. Clinical case records were studied in treated cases. A meticulous external and internal examination was made and the details regarding nature, dimensions and location of injury was entered in a proforma. The data were entered in MS Excel and statistical analysis was done.

RESULTS

Out of the 104 cases of railway occurrence, six cases (5.8%) were those with history of fall from running train and 20 (19.2%) cases were with history of jumping in front of train. External injury was present in all the cases. In all the cases, head showed lacerated wounds and the upper limbs showed abrasion. All the cases showed soft tissue injuries on the head and face. Fracture of the skull bone was seen in 66.6% of cases. Head alone was injured in 83.3% of cases and head and neck were involved in 1 case. Soft tissue injury was present in three cases (50%). Injury to chest was present in 66.6% of cases. In 50% of cases, the liver was found lacerated either alone (16.6%) or in combination with other viscera (33.3%). Chest alone and abdomen alone were injured in 1 case (16.6%) each. Chest along with abdomen was injured in 3 cases (50%). In two cases, there was transection of the body at the level of abdomen, in one of which the chest structure also was injured. External injury of pelvic region was present in 50% of cases, while fracture occurred in only one case. The upper limb showed fracture in two cases (33.3%); in one at single site (left elbow) and in the other at multiple sites. The lower limb showed multiple fractures (16.6%) in one case. In the case with fracture of the left elbow joint there was an abrasion on the back of left elbow, the upper four ribs on left side were fractured on the back aspect and head showed contusion with lacerated wound on right side. In Group II abrasions and lacerated wounds were the major types of injuries seen in this group showing a frequency of 90% each. In all the cases head showed lacerated wound, of which 35% were crushed lacerated wounds. Face alone showed injury in 5 (25%) cases. In 10 cases (50%) there was extrusion of brain, in which two cases (10%) showed decapitation and 3 cases (15%) cervical spine fracture. In two cases (10%), the spinal column was injured in between the VII cervical and I thoracic vertebrae. Two cases (10%) showed spinal cord contusion and in one case (5%) the spinal cord was lacerated. In 60% of cases, abdomen was found injured. Three cases (15%) showed transection of the trunk; one each at the level of chest, abdomen and pelvis. In 14 cases, chest was injured. The most frequently affected chest structure was rib (70%) and lung (60%).

CONCLUSION

High frequency of head injury was seen in cases with histories of fall from running train and jumping in front of train. Transection injuries were common in cases with history of jumping in front of train (15%). Extensive injuries were seen in cases with history of jumping in front of train, because the chance of getting overrun by the train was higher in this case and head and limbs were the most vulnerable regions to injury.

KEYWORDS

Pattern of rail track injuries, fall from running train, jumping in front of train, Railway accidents, Railway suicides.