Types of injuries and interrelated conditions of victims and assailants in attempted and homicidal strangulation

Abstract

The injuries of 79 surviving and 37 dead victims of strangulation were analyzed and compared with the injuries of their assailants. Other interrelated conditions of victims and assailants were also analyzed. The injuries of victims surviving strangulation were separated into six distinct types characteristic for strangulation, with one hand, with two hands from the front, with two hands from behind, by pressing the larynx with two thumbs, by ligature, and by putting the forearm or the elbow region around the neck. These types of injuries could also be recognized on the murdered victims. Besides the signs of strangulation, 43% of the surviving victims had head injuries. If the strangulation was attempted in connection with rape, the body injuries were usually not severe, but self-defence injuries were seen in 73% of the cases. The body injuries of the victims of maltreatment and murder were severe but self-defence injuries were seen only in 20% and 30% respectively. Conjunctival petechiae were seen on 14 out of 79 surviving victims but only 8 of them became unconscious and only 4 experienced sphincter incontinence, which suggests that the petechiae are not always a sign of life-threatening asphyxia but of local venous congestion. A regular relationship was noted between the presence of fractures of the hyoid bone and/or larynx, the ages of the victims and the manner of strangulation. The murderers were in more than 60% of the cases relatives or close friends of the victim. The connection between the victims and the murderers was sex-dominated: 38% of the victims were throttled by their regular or former sex-partner and 31% fell victim to a sex-murder. Suicide attempts of the throttler occurred in 5 out of 11 cases when the male sex-partner throttled his wife as a result of a matrimonial dispute or jealousy. Thirteen of the 20 physically examined throttlers revealed injuries which were inflicted during the murder. The most usual localizations of the injuries were the hands, forearms, face and neck, in which regions 3.8 injuries were found per throttler. Control persons revealed less than 2% of the number of injuries found on throttlers in these regions. Nail marks were the most common findings on the throttlers and their victims. The origin, morphology and medicolegal significance of the nail marks is discussed.