Puppe's Rule

  

                                                                       Georg Puppe

His most well-known discovery is the Puppe's rule, which allows the sequence of impacts of a blunt object on the human skull to be determined by means of an analysis of the fracture edges.

Puppe was the first to point out that it is possible to determine the sequence of injuries in skull fractures caused by blows to the head because the second fracture ends at the point where a break in cohesion is already present.

Even though this rule is true for all blunt injuries to the skull, it is of particular importance in gunshot wounds. The fracture lines created by every other shot extend only up to the fractured lines produced by the previous shot without continuing over them.

Puppe proposed the rule in the paper Traumatische Todesursachen in Gerichtliche Medizin in 1903. His name is often omitted when it is discussed in English language literature

Snapshot 

Puppes Rule: Skull Fractures 

Finds out the sequence of blows if the patient has multiple fracture lines

States that the second fracture line does not cross the old one