Fracture of Hyoid Bone

  • Hyoid bones fractures represent 0.002% of all fractures.
  • They are rare because the hyoid bone is well-protected by its location in the neck behind the mandible and in front of the cervical spine, as well as its mobility.
  • 91.3% of hyoid bone fractures occur in men.
  • It is most commonly associated with Manual Strangulation/Throttling or Hanging.
  •  Hyoid bone fractures are classified into three different types:
  • Inward compression fractures with outside periosteal tears-occurs in manual strangulation Antero-posterior compression fractures with inside periosteal tears-occurs in hanging
  • Outer displacement of hyoid bone fracture may be seen in case of hanging.
  • Avulsion fractures

 Clinical features:
  • Symptoms: dysphagia, odynophagia, hemoptysis and pain upon neck rotation or pain in the throat that worsens during coughing.
  • Signs:anterior neck tenderness, swelling, ecchymosis, subcutaneous emphysema and crepitus, on palpation.
Diagnosis :
  • Routine plain cervical X-rays in lateral orientation.
  • Other radiologic examinations such as orthopantomographic radiograph and computerized tomography are rarely needed mainly for the purpose of excluding associated comorbidities.
  •  In any case that dyspnea, hemoptysis or bleeding from laryngeal lacerations are present, direct laryngoscopy is recommended to recognize the extent of injury.
Treatment :
  • Mainly conservative.
  • Surgical intervention required in only around 10 % of cases.
Exam Question
  • On postmortem examination, contusion of neck muscles is seen along with fracture of hyoid bone. The most probable cause of death is Throttling.
  • Fracture of hyoid bone is indicative of Hanging or Strangulation or Throttling
  • Hyoid bone fracture does not occur in Choking.
  • Outward displacement of fractured hyoid bone is seen in Hanging.
  • Hyoid bone fracture most common occurs in Manual strangulation(Throttling)

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