Godin Anny, Kremer Célia, Sauvageau Anny
Laboratoire de sciences judiciaires et de médecine légale, Montreal, Quebec, Canada
Am J Forensic Med Pathol. 2012 Mar;33(1):4-7. doi: 10.1097/paf.0b013e3181d3dc24.
The distinction of a suicidal hanging from a simulated hanging following a homicidal strangulation is highly challenging. The present study evaluates the fracture of the cricoid cartilage as a potential pointer toward homicide. Despite the numerous studies on neck structures fractures in hanging, this is the first study to concentrate on the cricoid cartilage. Neck structures fractures in all cases of suicidal hanging over a 6-year period were retrospectively reviewed (231 cases) and a comparison with homicidal hangings (4 cases) and homicidal no-hanging strangulations cases (52 cases) was performed. Overall, neck structures fractures were found in 23.4% of suicidal cases (54 cases). The cricoid cartilage was intact in all suicidal hangings. The general incidence of fractures in homicidal no-hanging strangulation was 65.4% (34 cases),with an incidence of fracture of the cricoid cartilage of 20.6%. By compiling studies from the literature, only one cricoid cartilage over 2700 suidical hanging cases was found, whereas an incidence of 5 to 20% is found for homicidal strangulation. It is therefore proposed that the presence of a fracture of the cricoid in an apparent suicidal hanging should be considered highly suspicious.
区分自杀性缢吊与他杀勒颈后伪装的缢吊极具挑战性。本研究评估环状软骨骨折作为他杀潜在指征的可能性。尽管已有众多关于缢吊时颈部结构骨折的研究，但这是第一项聚焦于环状软骨的研究。对6年间所有自杀性缢吊案例（231例）的颈部结构骨折情况进行了回顾性分析，并与他杀缢吊案例（4例）和他杀非缢吊勒颈案例（52例）进行了比较。总体而言，23.4%的自杀案例（54例）出现了颈部结构骨折。所有自杀性缢吊案例中环状软骨均完整。他杀非缢吊勒颈案例的骨折总发生率为65.4%（34例），环状软骨骨折发生率为20.6%。通过汇总文献研究发现，在2700多例自杀性缢吊案例中仅有1例环状软骨骨折，而他杀勒颈案例的发生率为5%至20%。因此，对于看似自杀性缢吊但存在环状软骨骨折的情况应高度怀疑为他杀。
