In manual throttling (homicidal strangulation by hand), the thyroid cartilage and hyoid bone are frequently fractured. Which specific fracture pattern of the hyoid is MOST characteristic of throttling rather than hanging?
- A Fracture of the body of the hyoid in the midline
- B Avulsion fracture of the lesser cornu
- C Fracture of the greater cornu of the hyoid, typically bilateral ✓
- D Comminuted fracture of the entire hyoid arch
Correct answer: C. Fracture of the greater cornu of the hyoid, typically bilateral
Explanation
Manual throttling involves direct compression of the neck structures between the fingers and thumb; the greatest force is applied to the greater cornua of the hyoid, often fracturing them bilaterally. In hanging, the ligature's pressure is more diffuse and the hyoid fracture is less common, more often involving the body. The characteristic of bilateral greater cornu fracture strongly points toward manual strangulation. The fracture of the lesser cornu and comminuted pattern are much less typical.
Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.
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Written and medically reviewed by the StethoPrep medical team.