Pattern of injuries to neck structures in hanging-an autopsy study

Area of Science:

• Forensic Medicine
• Autopsy Studies
• Traumatology

Background:

• Hanging remains a significant cause of death worldwide.
• Understanding autopsy findings in hanging cases is crucial for medicolegal investigations.
• Previous studies have highlighted various injury patterns, but regional data is valuable.

Purpose of the Study:

• To analyze the external and internal neck injuries in medicolegal autopsy cases with alleged history of hanging.
• To correlate external ligature marks with internal pathological findings.
• To identify demographic patterns and common ligature materials used in hanging deaths.

Main Methods:

• Retrospective analysis of 189 medicolegal autopsy cases with alleged hanging.
• Detailed external examination of the neck, including flap dissection.
• Correlation of external findings (ligature marks) with internal injuries (muscle, cartilage, bone, vertebral column).

Main Results:

• Preponderance of males (70.9%) and middle-aged individuals (64.9%).
• Soft ligature materials (saree, shawl) were more common (47%) than hard materials (29%).
• Oblique ligature marks (94.2%) and non-continuous marks (78%) were prevalent; horizontal marks indicated partial hanging. Internal injuries included muscle fiber rupture (19.6%), hyoid bone fracture (2.7%), thyroid cartilage fracture (5.3%), and vertebral fractures (1.6%) in older individuals (>38 years).

Conclusions:

• Hanging deaths exhibit distinct demographic and ligature material patterns.
• External ligature mark characteristics correlate with hanging type and internal injuries.
• Age is a factor in the occurrence of neck skeletal injuries in hanging cases.