Fracture of the hyoid bone in mechanical asphyxial deaths and its medico-legal significance

Abstract

Introduction: Hyoid bone is a unique structure in the neck that has great medicolegal importance in cases of asphyxial deaths. Its complete examination can reveal important clues to the mode of death. We in the current study tried to evaluate the incidence of fractures of the hyoid bone in mechanical asphyxial deaths reported to our Hospital. Methods: This cross-sectional observational study was conducted in the Department of Forensic Medicine and Toxicology, Rajiv Gandhi Institute of Medical Sciences, [RIMS], Adilabad. A total of n=100 cases of compression of the neck by ligature due to hanging and Garroting were included.Detailed examination of the neck and surrounding structures was done.Results: Hyoid bone was found to be fracture with n=9(10.11%) cases out of n=89 cases of hanging. In garroting cases out of total n=11, all 100% were found to have hyoid bone fractures along with a fracture of the thyroid cartilage. In cases of garroting/strangulation cases, n=8 cases were fractured at the greater horn. N=2 fractures were found at the lesser horn and n=1 was found to have a fracture at the body of the hyoid bone. Conclusion: The fractures of hyoid bone were found with higher frequency in patients with age > 50 years. Multiple factors influence the fractures of the hyoid bone. Additionally, not only the hyoid bone but the surrounding soft tissues must be carefully examined for extravasation, because extravasation in soft tissues around the fracture reveals a true fracture.