Clinical features associated with forms of torture - Face injuries

Injuries, scars, lesions etc. on the face can be particularly distressing because they are constant reminders of the torture. Injuries are common over bony points especially the eyebrows and cheekbones. They could be associated with fracture of the malar (cheek) bone.

The face should be palpated for evidence of fracture, crepitation, swelling or pain. All cranial nerves should be examined. Appropriate radiological techniques should be used when possible to confirm facial fractures, determine alignment and diagnose associated soft tissue injuries and complications. Intracranial and cervical spinal injuries are often associated with facial trauma.

Mandibular fractures or dislocations may result from beatings. Temporomandibular joint syndrome is a frequent consequence of beatings, including forceful slaps about the lower face and jaw. The alleged victim should be examined for evidence of crepitation of the hyoid bone or laryngeal cartilage resulting from blows to the neck. Findings concerning the oropharynx should be noted in detail, including lesions consistent with burns from electric shock or other trauma. The maxillary labial frenum may be torn. Gingival hemorrhage and the condition of the gums should also be noted.

​The nose should be evaluated for alignment, crepitation and deviation of the nasal septum. For simple nasal fractures, standard nasal radiographs should be sufficient. Radiological techniques should be used to confirm fractures and identify soft tissue injury.