Burn Artifacts

During burning, changes occur that can mimic trauma and hinder identification (see Subheading 3.2.):

• Remnants of clothing around neck mimic ligature strangulation (Fig. 13).

• "Pugilistic posture" owing to muscle contraction from heat suggests "fight or flight"

• Splitting of skin and exposure of subcutaneum suggests incised wounds (see Fig. 4 and ref. 40).

• Heat blisters can form. They are either intact or open. A dried open area turns yellow to dark brown. These blisters are not necessarily a sign of vitality. Accelerants (kerosene, gasoline) can accentuate blister formation and skin slippage (49).

Fig. 10. Charred body. Teeth are protected from and more resistant to burning. (Courtesy of the Office of the Chief Medical Examiner, Chapel Hill, NC.)

Fig. 11. Charred body. Chest radiograph shows healed clavicle fracture (arrow). If ante-mortem radiographs have been disposed, and are not available for comparison, then a medical history of this injury still provides an identification consistency. (Courtesy of the Office of the Chief Medical Examiner, Chapel Hill, NC.)

Fig. 11. Charred body. Chest radiograph shows healed clavicle fracture (arrow). If ante-mortem radiographs have been disposed, and are not available for comparison, then a medical history of this injury still provides an identification consistency. (Courtesy of the Office of the Chief Medical Examiner, Chapel Hill, NC.)

Fig. 12. Charred body recovered from car fire. The only identifying feature described was a "webbed" toe. (A) Right forefoot. Presumed partial syndactyly between second and third toes (arrow). (B) Longitudinal autopsy cuts through web spaces. Upper section: fold of skin indicating partial syndactyly (arrow). Lower section: uninvolved web space (arrowhead).

Fig. 12. Charred body recovered from car fire. The only identifying feature described was a "webbed" toe. (A) Right forefoot. Presumed partial syndactyly between second and third toes (arrow). (B) Longitudinal autopsy cuts through web spaces. Upper section: fold of skin indicating partial syndactyly (arrow). Lower section: uninvolved web space (arrowhead).

Fig. 13. Burned necktie appearing as a ligature.

• A "red line" at the periphery of severely burned or charred skin mimics inflammation and suggests the victim was alive when the burns occurred (Fig. 14). Microscopic examination shows subepidermal blood.

• Heat fractures are not associated with soft tissue hemorrhage (49). Heat amputation of distal extremities is recognized by the presence of charring at the distal ends of the affected bones (Fig. 15). Similarly, charred skull fracture edges are indicative of heat effects. Heat fractures in the extremities are thought to arise from muscle shrinkage (47). Burning of the outer table reduces the strength of the bone. Heat-induced skull fractures are caused either by an increase in intracranial pressure caused by steam ("blow-out" fracture, i.e., fragments displaced outward) or desiccation of the outer table of the cranium (34,50). Heat effects can cause round holes in the skull suggesting a gunshot wound (Fig. 16 [50]). Herniation of cerebral tissue through the fracture defects can be seen (51). Observations regarding heat-induced skull fracture are contradictory. Fracture lines radiating from a skull defect are supposed to indicate a true injury (36). Calvarial heat fractures have been described as elliptical or circular without radiating fracture lines (cited in refs. 34 and 35). In contrast, Spitz observed several fracture lines radiating from a common center in burned skulls (47). A heat fracture of the calvarium is usually located above the temple and sometimes bilateral (47). These fractures are rarely limited to the external table (47). Cranial sutures tend not to burst even in a young individual; however, bursting of the coronal or sagittal suture was observed in a series of cremations (34,47).

• Disintegration of a burned body during extinguishing of fire by either rapid cooling of heated remains or disruption by water under high pressure hinders the assessment of trauma (48).

• Epidural hemorrhage, usually bilateral and associated with charring of the scalp and calvarium, is not the result of trauma (see refs. 42 and 49 and Fig. 17).

Fig. 14. "Red" line (arrows) at the edge between burned and unburned skin. (SeeCompanion CD for color version of this figure.)

• Shrunken, firm, yellow or light brown discolored ("cooked") brain is a heat artifact (47).

• Apparent exsanguination from the nostrils and mouth is observed as heat forces blood from the lungs into the airways (see Subheading 4.1., and ref. 47).

• Introduction of soot into the trachea, either during incision of the charred neck at autopsy or by disintegration from burning, gives the false impression of smoke inhalation (52).

• Treatment artifacts (see Subheading 5.2., Table 1).

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