Amaar A. Amir , Baraa A. Amir , Asim A. Alghannam , Tareq H. Abdeen , Rayan M. Alshneiber , Abdullah A. Alhowaish , Ritesh G. Menezes
{"title":"Systematic review of laryngohyoid fractures in fatal falls: A potential mimicker of strangulation","authors":"Amaar A. Amir , Baraa A. Amir , Asim A. Alghannam , Tareq H. Abdeen , Rayan M. Alshneiber , Abdullah A. Alhowaish , Ritesh G. Menezes","doi":"10.1016/j.jflm.2023.102612","DOIUrl":null,"url":null,"abstract":"<div><p><span>Fractures of the laryngohyoid complex are classically associated with deaths due to strangulation. Recent studies, however, indicate the possible presence of such fractures in fatal falls. The primary focus of this systematic review is to analyze the characteristics of laryngohyoid fractures in the context of falls to aid in a more accurate interpretation of autopsy findings. Search for relevant literature occurred on PubMed on the 26th of October 2022, and </span>Embase<span> and Web of Science on the 5th of November 2022. Inclusion criteria included being a primary study, published in English, involving fatal falls and injuries to the laryngohyoid complex, and presenting sufficient details about the relevant cases. Four case reports and six descriptive retrospective studies were included in the final analysis yielding a sum of 38 cases. The risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Potential limitations of this study include the inclusion of case reports and studies published in English only. The cumulative male-to-female ratio was 23:15 with a mean age of 48 years old. The fall height ranged from standing height to 60 m. Forty-three fractures to the laryngohyoid complex were identified with the thyroid cartilage most commonly affected, followed by fracture of the hyoid bone<span>, and finally the cricoid cartilage. While cases of falls did indeed display hallmark laryngohyoid findings classically displayed in strangulation, they also featured unique presentations such as fractures of the clavicle<span> and a reduced prevalence of conjunctival petechiae.</span></span></span></p></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of forensic and legal medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1752928X23001300","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, LEGAL","Score":null,"Total":0}
引用次数: 0
Abstract
Fractures of the laryngohyoid complex are classically associated with deaths due to strangulation. Recent studies, however, indicate the possible presence of such fractures in fatal falls. The primary focus of this systematic review is to analyze the characteristics of laryngohyoid fractures in the context of falls to aid in a more accurate interpretation of autopsy findings. Search for relevant literature occurred on PubMed on the 26th of October 2022, and Embase and Web of Science on the 5th of November 2022. Inclusion criteria included being a primary study, published in English, involving fatal falls and injuries to the laryngohyoid complex, and presenting sufficient details about the relevant cases. Four case reports and six descriptive retrospective studies were included in the final analysis yielding a sum of 38 cases. The risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Potential limitations of this study include the inclusion of case reports and studies published in English only. The cumulative male-to-female ratio was 23:15 with a mean age of 48 years old. The fall height ranged from standing height to 60 m. Forty-three fractures to the laryngohyoid complex were identified with the thyroid cartilage most commonly affected, followed by fracture of the hyoid bone, and finally the cricoid cartilage. While cases of falls did indeed display hallmark laryngohyoid findings classically displayed in strangulation, they also featured unique presentations such as fractures of the clavicle and a reduced prevalence of conjunctival petechiae.
喉舌骨复合体骨折通常与绞勒致死有关。然而,最近的研究表明,在致命的跌倒中可能存在这种骨折。本系统综述的主要重点是分析跌倒时喉舌骨骨折的特征,以帮助更准确地解释尸检结果。相关文献检索时间为2022年10月26日PubMed, 2022年11月5日Embase和Web of Science。纳入标准包括:一项以英文发表的主要研究,涉及致命跌倒和喉舌骨复合体损伤,并提供有关病例的足够细节。最后的分析包括4个病例报告和6个描述性回顾性研究,共38个病例。使用乔安娜布里格斯研究所(JBI)关键评估工具评估偏倚风险。本研究的潜在局限性包括纳入病例报告和仅以英文发表的研究。累计男女比23:15,平均年龄48岁。坠落高度从站立高度到60 m不等。43例喉舌骨复合体骨折中最常见的是甲状软骨,其次是舌骨,最后是环状软骨。虽然跌倒的病例确实表现出典型的绞勒喉舌骨特征,但它们也有独特的表现,如锁骨骨折和结膜积点的发生率降低。
期刊介绍:
The Journal of Forensic and Legal Medicine publishes topical articles on aspects of forensic and legal medicine. Specifically the Journal supports research that explores the medical principles of care and forensic assessment of individuals, whether adult or child, in contact with the judicial system. It is a fully peer-review hybrid journal with a broad international perspective.
The Journal accepts submissions of original research, review articles, and pertinent case studies, editorials, and commentaries in relevant areas of Forensic and Legal Medicine, Context of Practice, and Education and Training.
The Journal adheres to strict publication ethical guidelines, and actively supports a culture of inclusive and representative publication.