The hyoid bone fracture is a very rare fracture of the hyoid bone, accounting for 0.002% of all fractures in humans. It is commonly associated with strangulation and rarely occurs in isolation.
The fracture occurs In 50% of strangulations and 27% of hangings.
That 27% decreases dramatically where there is no drop of the body from a height or elevated position such as a chair or table.Epstein reportedly hanged himself by kneeling on the floor and though the breaking of the hyoid bone is possible in such circumstances, the likelihood is greatly decreased.
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washingtonreformer.com
Autopsy finds broken hyoid bone in Epstein's neck, typically associated with homicide.