Determinants of Internal Neck Injuries in Suicidal Hanging: A Cross-sectional Autopsy Study at a Tertiary Care Hospital in Western Maharashtra
DOI:
https://doi.org/10.48165/jfmt.2026.43.03.03Keywords:
Suicidal Hanging, Autopsy, Forensic Pathology, Internal Neck Injuries, Ligature Texture, Knot Position, Hyoid FractureAbstract
Hanging is the most common method of suicide in India. It requires careful medico-legal evaluation, as internal neck injuries such as soft-tissue haemorrhages, hyoid or thyroid cartilage fractures, and vascular tears provide insight into suspension mechanics. A descriptive cross-sectional autopsy study was conducted on 50 cases of suicidal hanging examined at a tertiary-care hospital in western Maharashtra between July 2018 and June 2020 to assess the frequency and predictors of internal neck injuries and their association with selected external factors. Demographic details, ligature material and texture, knot position, completeness of hanging, and internal neck findings were documented. Internal injury was defined as any soft-tissue haemorrhage, skeletal injury, vascular tear, or tracheal contusion. Data were analysed using frequency distribution, odds ratios with 95% confidence intervals, Fisher’s exact test, and binary logistic regression; p < 0.05 was considered significant. Internal neck injuries were observed in 18 cases (36%). Hard ligatures showed a significantly higher association with internal injuries (78.9%) than soft ligatures (9.7%) (OR 35.0; 95% CI 6.27–195.33; p < 0.001) and emerged as the primary independent predictor on multivariate regression analysis. Complete hanging demonstrated a higher proportion of injuries (66.7%) compared to incomplete hanging (29.3%), though this trend approached significance on conservative Fisher's exact testing (p = 0.0548) despitean elevated risk profile on interval estimation (95% CI: 1.03–22.56). Knot position showed no significant association (p = 0.744). Documenting these external characteristics is vital for accurate forensic suspension mechanics interpretation
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