Why Epstein’s Hyoid Bone Fracture Points to Homicide

When any case of hanging, strangulation or throttling comes to the Department of Forensic Medicine for Post-mortem examination, the hyoid bone becomes the most integral part of internal examination at the autopsy table. Many authors and workers in this field have seriously highlighted fracture of hyoid bone. Some have claimed hyoid bone fracture in about 20% cases of hanging. Some have claimed hyoid bone fracture in about 68% cases of hanging. They also claimed that hyoid bone fracture increases with age above 40 years due to calcification and immobilization of joints. Some also claimed that hyoid bone fracture increases with using hard ligature for hanging and strangulation. Fracture of hyoid bone has been ascribed to many factors like manners of constriction, level of application of ligature or force of constriction, long drop or short drop suspension, age of victim, sex of victim etc. Besides getting hyoid bone fracture at autopsy table, it is also very important to check whether it is ante-mortem or post-mortem in nature or just an artifact. For this difficulty some have even advised pre-autopsy X-ray of the neck structures to detect ante-mortem hyoid bone fracture. Observing the importance given to hyoid bone fracture in hanging, ligature strangulation and throttling cases by many authors at the past and present days, the present authors have taken up the study in 257 cases of hanging, 7 cases of ligature strangulation and 5 cases of throttling to notice that hyoid bone fracture is nil or very rare in hanging where as it is very common in both forms of strangulation. http://bit.ly/2Z6iGVj
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