ANATOMICAL CHARACTERISTICS OF HYOID BONE FRACTURES IN STRANGULATION CASES
Main Article Content
Keywords
Anatomical characteristics, hyoid bone, fatal consequences, forensic evidence, Strangulation
Abstract
Introduction: Strangulation is a form of asphyxia resulting from external compression of the neck, which can lead to severe, often fatal consequences.
Objective: The main objective of the study is to find the anatomical characteristics of hyoid bone fractures in strangulation cases.
Methodology: This observational study was conducted at Khairpur Medical College during June 2022 to December 2022. By reviewing historical autopsy records, the study seeks to elucidate the relationship between the presence and types of hyoid bone fractures and the mechanisms underlying strangulation.
Results: Data were collected from 35 patients' records according to criteria of the study. 22 (63%) had hyoid bone fractures. The age of the victims was distributed average 35 years, male 20 (57%), and female 15 (43%). In general, strangulation was followed by death within 12 hours, as calculated from the time of the incident. Other neck injuries were reported to be present in 63% of the cases: internal bleeding in the neck in 45%, neck abrasions in 68%, and laryngeal fractures in 32%. Details of the results In the 35 strangulation cases reviewed for the study, 63% of them had experienced hyoid bone fractures while 37% of them were negative to this aspect. This distribution explains why the hyoid bone belongs to the areas that should be focused on in cases of strangulation due to the often occurrence of its fractures.
Conclusion: It is concluded that hyoid bone fractures are prevalent in a significant proportion of strangulation cases, with horizontal fractures being the most common type. The presence and pattern of these fractures provide crucial forensic evidence that helps in understanding the dynamics of strangulation.
References
2. Baier, W., Burnett, B. A., Payne, M., Warnett, J. M., & Williams, M. A. (2020). Using micro-computed tomography to examine the larynx in cases of suspected strangulation—a comparison of case findings and control images. International journal of legal medicine, 134, 1441-1450.
3. Saternus, K. S., Schleser, C., & Trübner, K. (2022). Biomechanics of a previously unknown thyroid cartilage fracture in fatal strangulation. Legal Medicine, 54, 101999.
4. Karagwal, P., Mittal, P., Sharma, B., & Sharma, G. (2021). Hyoid bone fracture and an elucidation of circumstances in a case of ligature strangulation by garroting. Journal of Clinical Pathology and Forensic Medicine, 9(1), 1-8.
5. Amir, A. A., Amir, B. A., Alghannam, A. A., Abdeen, T. H., Alshneiber, R. M., Alhowaish, A. A., & Menezes, R. G. (2023). Systematic review of laryngohyoid fractures in fatal falls: a potential mimicker of strangulation. Journal of forensic and legal medicine, 102612.
6. Ubelaker, D. H., Cordero, Q. R., Wu, Y., & Linton, N. F. (2020). Anthropological analysis of trauma in throat bone and cartilage: a review. Forensic Science International: Synergy, 2, 224-229.
7. de Bakker, H. M., Warmbrunn, M. V., van den Biggelaar, P., Soerdjbalie-Maikoe, V., & de Bakker, B. S. (2021). Correction to: Fracture patterns of the hyoid-larynx complex after fatal trauma on the neck: retrospective radiological postmortem analysis of 284 cases. International journal of legal medicine, 135, 1105-1113.
8. Dursun, A., Ayazoğlu, M., Ayyıldız, V. A., Kastamoni, Y., Öztürk, K., & Albay, S. (2021). Morphometry of the hyoid bone: a radiological anatomy study. Anatomy, 15(1), 44-51.
9. Deininger-Czermak, E., Heimer, J., Tappero, C., Thali, M. J., & Gascho, D. (2020). Postmortem magnetic resonance imaging and postmortem computed tomography in ligature and manual strangulation. The American Journal of Forensic Medicine and Pathology, 41(2), 97-103.
10. Chouhan, A. S., & Baniya, B. (2022). Hyoid Bone also Known as Suicide Bone–A Case Report. Journal of Clinical Case Studies Reviews & Reports. SRC/JCCSR-151, 4(1), 2-4.
11. Nteli Chatzioglou, G., Toklu, E., Bayraktar, E., Ertaş, A., Kale, A., Coşkun, O., ... & Gayretli, Ö. (2023). Morphological and morphometric variations of the hyoid bone in anatolian population. European Journal of Therapeutics.
12. Mittal, P., & Sharma, B. (2023). Masquerading of homicidal strangulation as roadside accident-A case report. Journal of Indian Academy of Forensic Medicine, 45(3), 267-273.
13. Bohdziewicz, A., Wisniewska, J., Dzaman, K., Piskadlo-Zborowska, K., & Kubiczek-Jagielska, M. (2024). Injury of the Hyoid Bone as a Rare Complication in Cervical Spine Rehabilitation: A Case Report. Ear, Nose & Throat Journal, 01455613241234302.
14. Hansen, J. P., Larsen, S. T., & Jacobsen, C. (2024). Diagnostic accuracy of post-mortem computed tomography for fractures of the hyoid-larynx complex. International Journal of Legal Medicine, 1-15.
15. Ito, Y., Abe, A., Katayama, Y., & Adachi, M. (2021). Hyoid fracture concomitant with comminuted mandibular fracture: a case report. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology, 33(6), 619-622.
16. Samieirad, S., Sharifi Rayeni, A., & Tohidi, E. (2020). A rare case of hyoid bone fracture concomitant with a comminuted mandibular fracture. Journal of Maxillofacial and Oral Surgery, 19(1), 40-43.
17. Singh, M. K. C., Siew, S. F., & Lai, P. S. (2020). Isolated hyoid bone fracture in a child due to a fall. International journal of pediatric otorhinolaryngology, 139, 110443.
18. Keil, W. (2020). Obstruction of the respiratory orifices, larynx, trachea and bronchia. In Asphyxiation, Suffocation, and Neck Pressure Deaths (pp. 200-221). CRC Press.
19. Fronczek, J., & de Boer, H. H. Neck Trauma Deaths. In Forensic and Legal Medicine (pp. 308-314). CRC Press.
20. Mazzante, N. M. G., de Camargo, B. W. D. F., de Sanctis, P., Fogaça, J. L., de Campos Vettorato, M., Tremori, T. M., ... & Rocha, N. S. (2020). Post-mortem analysis of injuries by incomplete hanging in dog (Canis familiaris) through radiographs and forensic necropsy. Forensic Imaging, 20, 100350.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Hina Rukhsar
Demonstrator, Department of Forensic Medicine, Khairpur Medical College, Khairpur Mirs, Sindh – Pakistan.
Dr. Qurat-ul-ain
Assistant Professor, Department of Anatomy, Peoples’ University of Medical & Health Sciences for Women, Nawabshah, Sindh – Pakistan.
Dr. Mujeeb-ur-Rehman Sahito
Associate Professor, Department of Anatomy, Peoples’ University of Medical & Health Sciences for Women, Nawabshah, Sindh – Pakistan.
Dr. Shazia Begum Shahani
Professor, Department of Anatomy, Bilawal Medical College, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh – Pakistan.
Dr. Abdul Sattar Khan
Lecturer, Department of Biochemistry, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh – Pakistan.
Dr. Gunesh Kumar
Assistant Professor, Department of Pharmacology, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh - Pakistan.
Dr. Furqan Ahmed Bhatti
Lecturer, Department of Pathology, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh - Pakistan.
Dr. Hina Shaikh
Research Officer, Department of Molecular Biology & Genetics, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh - Pakistan.
Dr. Muhammad Yaqoob Shahani
Associate Professor, Department of Anatomy, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh - Pakistan.