Fracture of the hyoid bone is an infrequent finding in strangulation of children and young adults compared with victims over 40 years. The reason is:
- A Children have proportionally longer necks, dispersing the applied force
- B The hyoid bone is cartilaginous and elastic in youth and fuses with the greater cornua only around the age of 40 years ✓
- C The thyrohyoid membrane is thicker in young individuals
- D Manual strangulation is never attempted on children
Correct answer: B. The hyoid bone is cartilaginous and elastic in youth and fuses with the greater cornua only around the age of 40 years
Explanation
In children and young adults the body and greater cornua of the hyoid are joined by cartilage, making the bone mobile and resilient under compressive force. Fusion of the greater cornua with the body is completed only by about 40 years of age, after which the rigid bone fractures readily when squeezed. This is why hyoid fracture is a useful indicator of throttling mainly in older adults, and its absence in a young victim never excludes strangulation.
Reference: Knight's Forensic Pathology, 4th ed.
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