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Cianci V, Mondello C, Cracò A, Cianci A, Bottari A, Gualniera P, Gaeta M, Asmundo A, Sapienza D. Hyoid Bone Fracture Pattern Assessment in the Forensic Field: The Importance of Post Mortem Radiological Imaging. Diagnostics (Basel) 2024; 14:674. [PMID: 38611588 PMCID: PMC11011880 DOI: 10.3390/diagnostics14070674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Post mortem hyoid bone fracture findings may be attributable to various factors, including both the onset of acute mechanical asphyxia as it happens in manual strangulation and in charred corpses. In forensic practice, the discovery of corpses burned after death to hide their real cause of death is not uncommon: in these cases, the diagnostic challenge is even greater, as the action of flames is capable of both masking previously generated lesions and/or generating new ones, as occurs for hyoid bone fractures. The case concerns a 76-year-old man found charred in his bedroom. Almost complete body charring made it impossible to evaluate any external damage. Post mortem computed tomography (PMCT) was performed, and an evident bilateral fracture of the greater horn of the hyoid bone was detected. Although the absence of typical charring signs had steered the diagnosis towards post mortem exposure to flames, PMCT proved to be very useful in increasing the accuracy in correctly determining the cause of death. In particular, making use of Maximum Intensity Projection (MIP) hyoid bone reconstructions, it was possible to measure the medial dislocation angle of the fracture fragments and then to establish the applied direction of force, which acted in a lateral-medial way. A manual strangulation diagnosis was confirmed. The increasing importance of performing post mortem radiological exams as a corollary for conventional autopsy has been further confirmed.
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Affiliation(s)
- Vincenzo Cianci
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Legal Medicine, University of Messina, via Consolare Valeria, 1, 98125 Messina, Italy; (C.M.); (P.G.); (A.A.)
| | - Cristina Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Legal Medicine, University of Messina, via Consolare Valeria, 1, 98125 Messina, Italy; (C.M.); (P.G.); (A.A.)
| | - Annalisa Cracò
- Diagnostic and Interventional Radiology Unit, Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, 98125 Messina, Italy; (A.C.); (A.B.); (M.G.)
| | - Alessio Cianci
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy;
| | - Antonio Bottari
- Diagnostic and Interventional Radiology Unit, Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, 98125 Messina, Italy; (A.C.); (A.B.); (M.G.)
| | - Patrizia Gualniera
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Legal Medicine, University of Messina, via Consolare Valeria, 1, 98125 Messina, Italy; (C.M.); (P.G.); (A.A.)
| | - Michele Gaeta
- Diagnostic and Interventional Radiology Unit, Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital Messina, 98125 Messina, Italy; (A.C.); (A.B.); (M.G.)
| | - Alessio Asmundo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Legal Medicine, University of Messina, via Consolare Valeria, 1, 98125 Messina, Italy; (C.M.); (P.G.); (A.A.)
| | - Daniela Sapienza
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Legal Medicine, University of Messina, via Consolare Valeria, 1, 98125 Messina, Italy; (C.M.); (P.G.); (A.A.)
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Simonit F, Da Broi U, Giudici F, Sciarappa OE, Innocenti D, Desinan L. Autopsy findings in fire deaths in relation to manner of death: Analysis of autopsy records in Friuli, Italy (1993-2020). Leg Med (Tokyo) 2024; 67:102372. [PMID: 38154314 DOI: 10.1016/j.legalmed.2023.102372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
The determination of the cause and manner of death can be particularly difficult in burned and charred bodies and autopsy remains a key element in the investigation. In this study, 39 autopsy records of fire deaths were reviewed in relation to the manner of death (25 accidents, 8 suicides, 3 homicides and 3 instances in which the manner of death remained undetermined). The analysis focused on the study of the burns, the degree to which the bodies were consumed by fire and the evidence of signs of vital exposure to fire and of non-fire-related injuries. Total surface body area (TBSA) was found to be significantly higher (p = 0.02) in suicides than in accidents. Moreover, the degree of destruction according to the Crow-Glassman Scale and the presence of a pugilistic posture tended to be higher in suicides compared to accidental deaths, whereas such parameters were found to be variable in homicides. With regard to the anatomical distribution of burns, in contrast with the literature, the feet were affected by burning in all suicides, with a significantly higher prevalence than in accidents (p < 0.01). Traumatic non-fire related injuries were noted in all homicides (with no signs of vital exposure to fire), 1 complicated suicide, 1 undetermined death and 13 accidents. We found that very few studies have focused on the analysis of burn distribution and extension according to manner of death and that there is currently no standardised anatomical model with which to study these variables for forensic purposes.
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Affiliation(s)
- Francesco Simonit
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy.
| | - Ugo Da Broi
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy
| | - Fabiola Giudici
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Orazio Elia Sciarappa
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy
| | - Dario Innocenti
- Università degli Studi di Udine, Dipartimento di Studi Umanistici, Italy
| | - Lorenzo Desinan
- Università degli Studi di Udine, Dipartimento di Area Medica, Medicina Legale, Italy
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