Neck Structure Injuries in Hanging – Comparing Retrospective and Prospective Studies

Abstract

Deaths due to hanging are common among suicides. Various studies in the forensic literature have reported considerable differences in the frequency of hyoid bone or thyroid cartilage fractures and injuries to the musculature and the vasculature of the neck. Some important reasons to which these variations could be attributed include: lack of a common method for examination of neck structures, varying degrees of thoroughness in examining the neck structures and lack of seriousness in the documentation of the findings (as cases of hanging are almost always suicidal) thus affecting the results of retrospective studies. The present study was conducted retrospectively (1994 to 1999) and prospectively (2000 to 2003) on 108 cases of hanging. Seventy-one per cent of the cases were male and 29% female, aged between 15 to 60 years. Hanging was typical in 20% of cases and atypical in 80%; it was complete hanging in 46% of cases and incomplete in 54% of cases. Neck structure fractures were found to be more common in atypical complete hangings; the incidence was found to be 10% in the retrospective group and 27% in the prospective group. Contusions and lacerations of musculature were found in 20% of cases in the retrospective group and 34% in the prospective group, thus stressing the need for thorough postmortem examinations and meticulous documentation of the findings.

Evaluation of the potential killing performance of novel percussive and cervical dislocation tools in chicken cadavers

“…This was primarily because more than 50% of birds showed vertebral damage, failure of dislocation and trachea damage, which was indicative of severe crushing injury and inference of causing death by asphyxiation, which is a serious welfare concern (Gregory and Wotton, 1990;Sharma et al, 2005;Salim et al, 2006;Erasmus et al, 2010a).…”

“…Bird age affected both killing potential and device success, in both cases revealing that it was easier to cause anatomical trauma to younger birds and therefore easier to achieve a reliable kill. Young birds are less anatomically mature, and therefore bones and cartilage are less calcified and reinforced, as well as connective tissue being less fibrous, making dislocation and damage to the skull easier to achieve (Sharma et al, 2005;Comi et al, 2009). However, in terms of neck muscle and arterial tissue, aging can have a detrimental effect, with reduced elasticity in arterial walls and skeletal muscle, reducing stretching potential, therefore carotid arteries and neck muscle are more likely to tear when under strain (Benetos et al, 1993;Nair, 2005).…”

Fracture of the neck structures in suicidal hangings: A Retrospective study on contributing variables

“…The average age of victims without fractures of the neck structures was 31.7 compared to 42.6 for victims presenting with fractures. This result comes as no surprise: it has been demonstrated in several studies that the incidence of fractures increases with age [7][8][9][10][11][12][13][14][15][16][17] because neck structures become calcified and more brittle in middle and later life [3,[22][23][24]. Bony fusion of the greater horn and body of the hyoid bone is rare in an individual under 20 years old and increases with advancing age [22].…”

“…It has been repetitively demonstrated that the incidence of fractures increases with age [7][8][9][10][11][12][13][14][15][16][17]. The role of gender is less clear: some authors found a male predominance of fractures [9,15,18] whereas other observed a female predominance [7,13] or no significant difference between genders [11,19].…”

“…complete hanging with feet off the ground or incomplete hanging with body parts partially supporting the weight of the body) [7,9,13,14,20], the type of ligature [7,9,16], the location of the knot or the highest suspension point [9,10,12,13,19] and the suspension time [13,15]. However, most of these studies evaluated these factors independently of the age of the victims.…”