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
- 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.
- 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.
- Mainly conservative.
- Surgical intervention required in only around 10 % of cases.
- 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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