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Keywords

Clinical Practice in Athletic Training

Abstract

Introduction: The hyoid bone plays an important role in speaking, swallowing, and supporting the tongue. Hyoid bone fractures account for 0.002% of all fractures and are typically seen in cases dealing with strangulations or a blunt force trauma such as occurs from vehicle accidents or martial arts injuries. Signs and symptoms of hyoid fractures can include dyspnea, pharyngeal tear, or subcutaneous emphysema, and if not recognized early can significantly damage the airway. Patient Information: A 23-year-old male collegiate football player sustained blunt trauma to the anterior part of his neck due to a tackle forcing the helmet chin strap against his throat. He reported immediate pain, painful swallowing, a sore neck, and difficulty breathing. On-field evaluation revealed anterior neck tenderness but overall stable airway function. Laryngeal contusion, pharyngeal tear, or cricoid cartilage fracture were all suspected initially. After the game, the athlete was referred to the emergency department for evaluation and imaging. There, the athlete received a computerized tomography scan (CT) which confirmed a non-displaced hyoid bone fracture with a paratracheal and superimposed muscular strain of the suprahyoid and infrahyoid muscles. Interventions: The patient was treated conservatively with analgesics for pain and prescribed a soft diet for two weeks to avoid strain on the neck. Practice, conditioning, and weight training were also restricted for two weeks. Outcomes: Imaging two weeks post-injury showed that the fracture was healing. The athlete was cleared for conditioning and weightlifting activities but was instructed to wait an additional week before returning to full contact practices. When returning to contact activities, the athlete was required to wear high-collar shoulder pads, a loosened chin strap and was instructed to ensure proper fitting of his helmet. The athlete made a full recovery; however, his anxiety about reinjury influenced his emotional well-being, highlighting the need for a comprehensive rehabilitation approach that addressed both physical recovery and psychological readiness. Missing games during his senior year created significant stress for him, subsequently impacting his mental health and overall sense of readiness. His absence from practice and conditioning affected his physical wellness, requiring a structured return-to-play plan to restore strength and confidence. Despite being unable to compete, he remained actively engaged by attending team meetings, participating in practices where possible, and checking in daily with the athletic trainers. Clinical Bottom Line: This study outlined a hyoid bone fracture and muscular strain caused by blunt trauma to the anterior neck in a 23-year-old collegiate football player. Following evaluation and imaging, the athlete was treated conservatively with rest, pain medication, and a soft diet. The athlete made a full recovery and returned to full football participation without restrictions after three weeks. Fractures of the hyoid bone are extremely rare in sports because of the positioning and anatomical location of the bone. Physicians and athletic trainers should be familiar with the subtle signs of hyoid bone fractures including tenderness in the throat area, potential voice changes, and breathing difficulties. This case highlights that standard football equipment does not sufficiently protect the neck from direct impact. Improving the protective equipment and ensuring proper fit may help reduce anterior neck injuries. This case can be used to help identify those signs and symptoms associated with hyoid fractures and highlight the need for continuous enhancements of safety protocols to prevent similar injuries.

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