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Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
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Complex fracture patterns in hanging associated with a fall from height.

Alberto Amadasi1, Claas T Buschmann2, Michael Tsokos2

  • 1Department of Medical and Surgical Sciences, Section of Legal Medicine, University of Bologna, Via Irnerio 49, 40126, Bologna, Italy. albertoamadasi@libero.it.

Forensic Science, Medicine, and Pathology
|December 18, 2019
PubMed
Summary

A rare hangman's fracture, involving cervical spine and hyoid bone injuries, occurred in a suicide by hanging combined with a fall. This case highlights unique trauma patterns from combined hanging and falling mechanisms.

Keywords:
Fall from heightForensic pathologyHangingHangman’s fractureNeck injuries

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Area of Science:

  • Forensic Pathology
  • Traumatology
  • Radiology

Background:

  • The 'hangman's fracture' is a rare injury pattern associated with hanging, typically involving cervical spine trauma.
  • Suicide by jumping with suspension by a ligature can involve both hanging and fall forces.

Observation:

  • A case study of an 81-year-old man who died by suicide via jumping from a bridge with a ligature around his neck.
  • The deceased sustained extensive cervical spine and hyoid bone fractures, vertebral column dislocation, and multiple bone fragments.
  • Computed tomography revealed a rare transverse full-thickness fracture of the dens.

Findings:

  • The combination of hanging and falling forces resulted in complex and peculiar fracture patterns in the cervical spine.
  • A transverse fracture of the dens, a rare finding, was identified, indicating severe axial loading and hyperextension.
  • The injuries demonstrate a unique pattern distinct from typical hanging or fall-related trauma.

Implications:

  • This case underscores the severe biomechanical forces generated by combined hanging and falling mechanisms.
  • Highlights the importance of detailed radiological examination, including CT, for identifying subtle but critical injuries.
  • Emphasizes the necessity of a multidisciplinary approach involving forensic pathology and radiology for accurate case interpretation.