Hyoid Dislocation Following Subacute Fracture in an American High School Football Athlete

Musculoskeletal injuries are exceedingly common in American football because of the contact-and-collision nature of the sport. More than 350,000 injuries are documented in the >1 million high school athletes participating in American football annually. Injuries to the neck are largely uncommon, composing only *6% of the injury total; however, if they are not properly diagnosed and treated, they can lead to severe, potentially fatal consequences. Lying in the anterior midline of the neck and well protected by the mandible superiorly, the cervical spine posteriorly, and thyroid cartilage anteriorly is the U-shaped hyoid bone. As the only bone in the body not articulating with any other bone, the hyoid functions to maintain patency of the pharynx for swallowing and respiration while serving as an attachment point for the middle pharynx. The hyoid is rarely susceptible to direct trauma, with fracture rates accounting for only 0.002% to 1% of all fractures and with dislocations being even less common. However, hyoid injuries with resultant bony penetration into the pharyngeal mucosa may compromise the patency of the airway, injure the external carotid artery, or cause infection. The majority of documented hyoid injuries occur in victims of strangulation, hanging, or motor vehicle accidents. Reported hyoid fractures following sports-related trauma are exceedingly infrequent, with only 6 total cases documented in the literature: football (n 1⁄4 2), basketball (n 1⁄4 2), hockey (n 1⁄4 1), and karate (n 1⁄4 1). There are currently no reports of hyoid dislocation secondary to sport-related trauma. In this case report, we present a high school football player presenting with an acute hyoid dislocation in the setting of a subacute fracture sustained 6 weeks prior.