Fractures of the hyoid bone and laryngeal cartilages in suicidal hanging

A prospective study of neck trauma associated with suicidal hanging was undertaken at the Forensic Science Centre, Adelaide over a 3-year period from July 1996 to June 1999. There were a total of 40 cases of suicidal hanging with an age range of 17-74 years (average = 35 years; M:F = 33:7). Fractures of neck structures were identified in 19 cases (47.5%) and were more common in older victims and males. Nine victims had only thyroid cartilage fractures (22.5%), four victims had only fractures of the hyoid bone (10%), and six victims had fractures of both the hyoid bone and thyroid cartilage (15%). No fractures of the cricoid cartilage or cervical spine were demonstrated. Potentially confusing issues encountered in the assessment of possible fractures of neck structures included cases where there was congenital absence of the greater horn of the thyroid cartilage, where accessory nodules of cartilage were present in the posterior margin of the thyrohyoid membrane, and where there had not yet been bony fusion of the cartilaginous joints between the greater horns and body of the hyoid bone.