What specific neck fractures were reported in Epstein’s autopsy and how do forensic pathologists interpret them?

1. What the autopsy reportedly found: which bones were broken

Contemporary news reports and sources familiar with the examination said Epstein “sustained multiple breaks in his neck bones,” specifying a broken hyoid bone and additional fractures in the thyroid cartilage (sometimes described as fractures of the larynx or thyroid cartilage); some observers described left and right thyroid cartilage fractures and a fractured left hyoid in the autopsy photographs ^{[1] [3] [2]}.

2. How many fractures and the phrasing used by observers

At least one prominent outside pathologist, Michael Baden, described “three fractures in the hyoid bone, the thyroid cartilage” when speaking for Epstein’s family, and multiple outlets summarized the autopsy as showing several breaks rather than a single fracture, though the official, full autopsy report was not immediately public in initial reporting ^{[4] [5]}.

3. Why those particular fractures matter in forensic analysis

Forensic pathologists flag the hyoid and thyroid cartilage because they are small neck structures that can fracture when the neck is compressed; a fractured hyoid is commonly associated with manual strangulation but can also occur in hangings—especially in older adults whose bones may be more brittle—so the injury itself cannot, in isolation, prove manner of death ^{[6] [3] [1]}.

4. Competing expert interpretations: homicide vs. suicide

Michael Baden, the private pathologist retained by Epstein’s family, argued the combination and pattern of fractures were “very unusual” for suicidal hanging and more consistent with homicidal strangulation, a view echoed in media coverage of his comments ^{[4] [7]}. By contrast, the New York City medical examiner’s office, which ruled Epstein’s death a suicide, cautioned against drawing conclusions from any single autopsy finding and emphasized that cause and manner are determined by synthesizing autopsy findings with investigative context such as scene evidence, surveillance and psychological history ^{[8] [3]}.

5. What independent forensic commentators and investigations said about interpreting the fractures

Multiple forensic experts consulted by outlets noted that neck fractures can and do occur in both mechanisms; several emphasized that age matters—older victims of hanging are more likely to sustain hyoid fractures—and that photographs of body position, ligature placement and full autopsy documentation are needed to interpret injury timing and mechanism, a limitation repeatedly highlighted in reporting ^{[6] [2] [5]}.

6. Limits of the public record and why disagreement persisted

News coverage repeatedly noted that the detailed autopsy report and some investigative materials were not fully public, and that experts reviewing photographs and summaries reached different conclusions because key contextual data—exact body position, full autopsy text, scene photos and contemporaneous surveillance—were missing or disputed; subsequent official reviews and oversight inquiries referenced the medical examiner’s findings but the public debate over interpretation continued ^{[9] [2]}.

Conclusion: what can be stated with confidence

What can be stated firmly from the reporting is that Epstein’s autopsy showed multiple neck fractures, including at least a fractured hyoid and fractures of the thyroid cartilage, and that forensic experts disagree about what those fractures signify: some see them as strongly suggestive of homicidal strangulation while the medical examiner and other pathologists say such fractures can occur in suicidal hanging—particularly in older men—and that no single injury alone determines manner of death ^{[1] [4] [3]}.