Frequency of throat-skeleton fractures in hanging

A total of 109 cases of suicidal or accidental hanging were evaluated and the number of hyoid bone or thyroid cartilage fractures or both was investigated in relation to the highest point of the ligature mark. In 73 cases (67%), at least a single fracture of the throat skeleton was detectable, and the youngest individual with positive findings was aged 14 years. In 28 of the 73 positive cases (38%), a single fracture was found, whereas 27 individuals (37%) showed a twofold injury. Three fractures of the throat skeleton were observed in 11 cases (15%), and in seven individuals (10%), all the horns of the hyoid and thyroid cartilage were broken. The youngest individual with four fractures was 28 years old (elastic non-ossified throat skeleton). Even though a higher incidence of positive results and in particular of multiple fractures could be established in cases with a highest point of the ligature mark at or behind the ears, no clear correlation between frequency and number of throat-skeleton fractures was detectable in our series.