Hanging is defined as a constriction of the neck because of force applied as a result of suspension by the weight of at least part of the body (Fig. 3; refs. 3 and 43). The typical hanging death involves tightening of a ligature, but this is not necessary (29,44). Accidental hanging may not involve a ligature (see Subheading 2.1.5. and ref. 28). Although hanging is a form of ligature strangulation, the latter implies neck constriction from a ligature not tightened by the body's weight during suspension. In rare cases, a neck ligature is tightened by a suspended weight applied by a supine individual (45,46). Additional outside force is sometimes applied to tighten the ligature (e.g., motor vehicle, elevator [44,47,48]).

The amount of body weight involved tightening the ligature depends on the position of the body. Khokhlov determined the following (49):

Position % of Body weight involved stretching ligature

Standing, toes touching floor 98%

Standing, feet flat >65%

Kneeling, buttocks down 74%

Kneeling, buttocks up 64%

Hanging Forensic Pathology
Fig. 3. Hanging in sitting position.

Sitting, back inclined down 32%

Sitting, back upright 17.5%

Recumbent, prone 18.3%

Recumbent, supine 9.7%

In studies of hanging deaths in Australia and Northern Ireland, fewer than half of the bodies were completely suspended. About 40% of the Australian victims were standing (16,43). Hanging lying down occurred in 1% of cases. This was also observed in the Northern Ireland series (50). If the point of suspension is high, a means of elevation (e.g., stool, box, or ladder) may be nearby (50).

The following weights have been observed to compress or damage neck structures (8,49):

Airway (level of thyrohyoid membrane) 10 kg (22 lb)

Trachea Vertebral artery Fractures

Thyroid cartilage lamina

Cricoid cartilage

Studies of fresh human larynges show that thyroid and cricoid cartilage fractures occur with the application of static forces averaging 15.8 and 20.8 kg (34.8 and 45.8 lb), respectively (51). Dynamic forces (velocities up to 11 mph or 18 km/h) cause fractures at forces averaging 30% more. Imminent structural collapse and severe fatal airway compromise occurred when the force averaged 55 kg (121 lb).

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