Bockholdt Britta, Hempelmann Marc, Maxeiner Helmut
Department of Legal Medicine, Free University Berlin, Hittorfstr 18, 14195 Berlin, Germany.
Leg Med (Tokyo). 2003 Mar;5 Suppl 1:S252-5. doi: 10.1016/s1344-6223(02)00142-6.
Fractures of the upper thyroid horns are a frequent finding after a variety of neck injuries - resulting from a direct mechanical trauma, e.g. compression of the neck in manual strangulation or ligature strangulation, from blunt injuries (falls or blows against the neck), and sometimes from indirect trauma (whiplash-injuries). Although it is well known that thyroid horns can be broken with relatively little pressure, no quantitative data are available in the literature. In an experimental investigation, the isolated thyroid cartilage was prepared (divided into two parts, measured, X-rayed, photographed, embedded in paraplast) and clamped in a simple apparatus. Weight was applied on the upper thyroid horn (imitating pressure on the horns), beginning with 1 kg and gradually increased by increments of 250 g to a maximum of 8 kg, until an 'injury' occurred. In this study, 120 thyroid cartilages (77 men, 43 women, 16-95 years) were investigated. The location of the fractures was in nearly all cases the base of the horns. The mean weight resulting in an injury of the horn was 3 kg (men: 3.3 kg, women: 2.6 kg). The required weight was dependent on the degree of ossification. The highest rate of fractures was found in cases with incomplete ossification; in cases without ossification, specimens often remained macroscopically uninjured.
甲状腺上角骨折在各种颈部损伤后很常见，这些损伤可由直接机械创伤引起，如手扼颈或勒颈时颈部受压、钝性损伤（跌倒或颈部受打击），有时也可由间接创伤（挥鞭样损伤）导致。尽管众所周知，相对较小的压力就能使甲状腺角骨折，但文献中尚无定量数据。在一项实验研究中，制备了离体甲状腺软骨（分成两部分，测量、进行X线检查、拍照，包埋于石蜡中），并夹在一个简单装置中。在上甲状腺角施加重量（模拟对角的压力），从1千克开始，以250克的增量逐渐增加至最大8千克，直至“损伤”发生。在本研究中，对120块甲状腺软骨（77名男性，43名女性，年龄16 - 95岁）进行了研究。骨折部位几乎均在角的基部。导致角损伤的平均重量为3千克（男性：3.3千克，女性：2.6千克）。所需重量取决于骨化程度。骨化不完全的病例骨折发生率最高；在未骨化的病例中，标本通常在宏观上未受损伤。
