In December 1988, the Harrison County, Mississippi, sheriff's office recovered the skeletal remains and clothing of a child in a wooded area. Forensic anthropologic analysis revealed that most skeletal bones were present. The complete lack of soft tissue and odor, the extent of bone staining, and preservation of the remains suggested that death occurred shortly after she was reported missing in August 1988. No evidence of trauma or foul play was observed other than postmortem animal chewing. The hyoid was recovered, but showed no evidence of trauma. Investigators questioned to what extent the lack of trauma on the skeleton, including the hyoid, was consistent with strangulation. Published literature on the traumatic involvement of the hyoid and related hard tissue of the neck shows that perimortem hyoid fracture frequently indicates manual strangulation, although ligature strangulation, hanging, and other forms of trauma to the neck cannot be ruled out without additional evidence. The literature suggests that, in all types of strangulation, the thyroid is the most likely neck structure to be fractured. Fracture of the hyoid is most common in manual strangulations in which about 34 percent of all victims show a fractured hyoid, 34 percent fractured thyroid, and 1 percent fractured cricoid. In ligature strangulations, the frequency of hyoid fracture falls to about 11 percent compared to 32 percent thyroid and 9 percent cricoid. Hangings produce only 8 percent fractured hyoids, 15 percent fractured thyroids, and 0.003 percent fractured cricoids. The literature strongly suggests that hyoid fractures are rare in children and infants, since hyoid components are not fully ossified and are more flexible than in adults. Both antemortem and postmortem fracture origins must also be considered. 36 references