Fracture of the hyoid bone in survivors of attempted manual strangulation.

Fractures of the hyoid bone are known to occur in 17-71% of fatalities following manual strangulation, but are infrequently recognised in survivors. Two cases are presented of attempted manual strangulation in young women (aged 30 and 35 years) in which lateral neck X-rays disclosed an isolated fracture of the greater horn of the hyoid bone. In both cases the X-rays were performed because the victim complained of symptoms: one victim complained of pain on swallowing and on neck movement. The other complained of pain on speaking and swallowing. Radiological demonstration of an isolated hyoid fracture is of great evidential value in criminal proceedings in cases of attempted manual strangulation, especially when presentation to the police authorities is delayed and external evidence of neck injury may be minimal. Consideration should be given to obtaining X-rays in those cases where symptoms persist.