1Additional Professor, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Patna, Bihar
2Junior Resident (Academic), Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Patna, Bihar
3Ex-Senior Resident, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Patna, Bihar
4Senior Resident, Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Patna, Bihar
*Corresponding Author Himanshi Narang, Email: himanshin07@gmail.com, Mobile No.: +91-9053875296
Online published on 10 February, 2023.
Fracture of hyoid and laryngohyoid complex may result from violence like strangulation, hanging, accidents, therapeutic interventions or postmortem processing. Inward compression fracture of hyoid bone usually indicates strangulation, and unexpected finding of hyoid fracture may cast suspicion of throttling or manual strangulation and may misguide the investigation. Here, we report a case of a rare, occurring inward compression fracture of hyoid bone identified in the autopsy examination of a 41-year-old decedent male who committed suicide by complete hanging.
A 41-year-old man decedent committed suicide by complete hanging with a thin, cord-like nylon rope. At autopsy, the authors observed a typical incomplete, obliquely placed grooved ligature mark on the neck. After achieving a bloodless field in the neck, layer by layer dissection was done. Internal examination revealed inward displaced greater cornu of the hyoid bone suggesting periosteal tear of the outer side at the junction of the body with right greater cornu. The displaced fragment was mobile in one direction, offering one degree of movement freedom. This finding of inward compression fracture of the hyoid is rare in hanging. Focal bleeding at the site confirmed the fracture and proved its intravital nature.
Fracture of hyoid following strangulation or hanging is well documented in the literature. In a suspected case of compression of the neck, fracture of the hyoid bone indicates throttling. However, the presence of unexpected fracture of the hyoid bone in a case of hanging may create confusion, raising the possibilities of direct trauma to the neck and possibly third-party involvement. It is, therefore, essential that the forensic pathologist adopt proper dissection techniques in interpreting injuries to the osseocartilaginous structures of the laryngohyoid complex.
Trauma, Laryngohyoid complex, Hyoid bone fracture, Inward compression, Hanging, Forensic Medicine
