A Fracture of the Hyoid Bone can Lead to Vertebral Injuries

A Fracture of the Hyoid Bone can Lead to Vertebral Injuries

I’m Ed Smith, a Sacramento Personal Injury Lawyer. There are many bones that make up the neck and while many people are familiar with the vertebrae that go up and down the neck, there are other structures on the front of the neck as well. One of these bones is called the hyoid bone and has the potential to be fractured just like any other bone. When this structure is injured, it is often as an isolated fracture; however, a recent case report has demonstrated that the vertebrae that make up the neck could be injured as well.

What is a Fracture of the Hyoid Bone?

The hyoid bone is a small structure that rests on the front of the neck. It helps to protect some of the most important structures in the body, such as the esophagus and the trachea. Because of its location, it is rarely injured; however, the most common way that this bone is broken is as part of a physical assault that results from the strangulation of someone. When a person is being strangled and leads to a fracture of the hyoid bone, it is often in association with an injury to the trachea or the esophagus; however, fractures are often rare unless they are facial fractures or a fracture of the mandible. Fractures of the vertebrae in the spine that run down the back are unusual; however, a recent case report demonstrates that this is possible.

Injuries to the Atlas and Axis

A recent case report was published that described a patient who developed a fracture of their hyoid bone in a traumatic injury that was accompanied by injuries to both the atlas and the axis. These are two of the most important vertebrae in the spinal cord because they are C1 and C2, at the top of the cord. These cervical vertebrae rest just below the brain stem. Some patients are at risk of injuring these two vertebrae, particularly those with Down Syndrome because they suffer from atlantoaxial instability. For most people who injure these vertebrae, they do so in combination with a traumatic brain injury, often by diving into a pool that is far too possible to accommodate such a dive. In this example, the patient dives into a pool that is too shallow and impacts the bottom of the pool with the top of their skull. This means that these forces are transmitted through the top of the head and down the back through C1 and C2. C2 sticks up into C1 and when these two vertebrae are compressed together, they shatter and the “spike” of C2 slides through C1, impacting the brain stem. This leads to a fatal brain injury because the ability to regulate the patient’s breathing and heart rate are lost. Injuries to these two vertebrae were recently described in a case report in combination with a hyoid fracture.

A Case Report of a Hyoid Fracture with Vertebral Injuries

The patient is a middle-aged man who was involved in a motor vehicle accident who then started having difficulty swallowing with extreme pain in his neck that was worsened while eating. The patient had an extensive physical exam and was taken for imaging of his neck as a result of his symptoms. The doctors ordered a CT scan of the head and neck to get a better look at what was going on underneath. They discovered a fracture of the hyoid bone in the front of the neck; however, they were surprised when they saw other injuries. They found a subluxation of the atlas and axis with the hyoid bone fracture. The patient was taken to the ICU for two days because of his breathing problems. The patient was treated for his subluxation and was watched closely for any complications that might result from this injury, such as respiratory distress syndrome. The patient was placed in a cervical collar and slowly allowed to eat again. After around three months, the patient had made a full recovery and did not have any major complications with his medical therapy.

The Study Significance

The implications of this study are important because there are not very many case reports of injuries to the hyoid bone published. Those that are published only describe an often isolated injury to the hyoid bone without any other types of fractures; however, it is important for physicians and patients everywhere to remember that other injuries are possible. If the doctor is not looking for other injuries, potential vertebral fractures and dislocations could be missed. These could be grave complications for the patient, particularly with the implication of fractures of the back. These could be costly injuries, particularly if sustained in a physical assault. Those who are struggling to find ways to pay their medical bills after a serious injury should remember that there are legal routes to help pay these costly bills. An experienced personal injury attorney can provide assistance in filling out paperwork, dealing with insurance companies, and, potentially, going to court to recover compensation for your losses.

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I’m Ed Smith, a Sacramento Personal Injury Lawyer. If you’ve been injured in an accident, call me for free, friendly advice at (916) 921-6400 or (800) 404-5400.

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Image Attribution: The image at the top was used from Wikimedia Commons with permission from the CC BY SA License, version 3.0.

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