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At least 19 recordsLinked to original sources
PubMed2005

Acute disposition of neck injuries.

Neck injuries can be some of the most serious and anxiety-producing injuries that occur during sporting events. It is important for the team physician to be prepared for the care of these injuries and be able to identify some of the more serious injuries. Proper care of these injuries can be life saving and prevent further injury and permanent disability. This article reviews the principles of management and latest evidence for acute neck injuries.

Athletic Injuries↗
PubMed1998

Epidemiology of athletic neck injury.

Neck injuries in sports are common, typically debilitating, and quite predictable in retrospect by mechanism of injury as to one of four natures--sprains/strains, fractures, brachial plexus pinches/stretches, and spinal cord injury. Of these, the spinal cord injury, whether a concussion or contusion or physical disruption, is obviously the most severe and also, ironically, the best tracked because of its definition and notoriety when it is experienced. This article discusses the essence of what has been learned epidemiologically over recent decades since the advent of organized attention to spinal cord injuries among athletes.

Athletic Injuries↗
PubMed2000

[Penetrating injuries of the neck, injury pattern and diagnostic algorithm].

Penetrating neck injuries are potentially life-threatening injuries. Management is controversial despite decades of discussion in the literature. An algorithm for diagnosis and therapy is needed because of the potential risk of mortality. In the Department of Trauma Surgery of Vienna Medical School, mandatory surgical exploration after noninvasive investigations is practiced. Thirty-one patients with this kind of injury were treated between August 1992 and September 1999. Injuries were caused in seven cases by gunshots, in eight cases by broken glass, in one case by an iron rod, in one case by a spear, in one case by a branch and in 13 cases the penetrating injuries were stab wounds caused by knives. Complications like pseudoaneurysms and fistulas were not seen. No patient came to death.

Adolescent↗
PubMed2004

High-risk head and neck movements at high G and interventions to reduce associated neck injury.

BACKGROUND: Neck injuries are a significant concern for aviators of high performance aircraft. A recent comprehensive technical report on cervical spinal injury associated with exposure to sustained acceleration, from NATO's Research and Technology Organization, recommended delineating the neck muscles used by aviators in this flying environment and developing improved neck muscle strengthening programs in an attempt to reduce such injuries. METHODS: A review of current literature was conducted in the fields of biomechanics, ergonomics, orthopedics, neurology, neurosurgery, rehabilitative medicine, and aerospace medicine. An objective description is provided of the muscles involved in specific head and neck movements, and those movements that are associated with a greater risk of injury during high-G sorties. The intensity and duration of force exposures common to high performance aircraft sorties, the effects of seat-back angle on these exposures, and the types and mechanisms of neck injury reported in this environment are also described. RESULTS: Primary, secondary, and tertiary preventive interventions are introduced with the goal of providing unit-level flight surgeons an approach to reducing neck injury and promoting prompt, safe return to flying of aviators with identified neck injury. A central component of these interventions is a "specific" and "intensive" neck muscle training regimen, as described in the medical literature. CONCLUSION: Increased axial compressive force and unique biomechanics combine to make neck injury likely in high performance aviators. The application of some proposed intervention strategies may reduce the occurrence of these injuries.

Acceleration↗
PubMed1991

Management of penetrating neck injuries. The controversy surrounding zone II injuries.

Penetrating neck injuries present a difficult challenge in management, given the unique anatomy of the neck. Controversy surrounds the approach to zone II injuries; mandatory versus selective exploration. On the basis of an extensive literature review, the authors conclude that neither approach is obviously superior. A selective approach is safe in the asymptomatic and hemodynamically stable patient, provided that accurate invasive diagnostic means are immediately available. The mandatory approach is safe, reliable, and time tested. The greatest problem appears to be the accuracy of detection of cervical esophageal injuries: Radiologic evaluation may be inaccurate, rigid esophagoscopy carries a risk of perforation, and the injury may easily be overlooked during surgical exploration.

Carotid Artery Injuries↗
PubMed2000

Neck injuries in frontal impacts: influence of crash pulse characteristics on injury risk.

AIS1 neck injuries are the most frequent disabling injuries among car occupants in road traffic accidents. Although neck injury is mostly regarded as resulting from rear end collisions, almost one third of all neck injuries occur in frontal impacts. The injury mechanisms in both rear-end and frontal impacts are still not known, although different hypotheses exist. Since 1992, approx. 100,000 vehicles on the Swedish market have been equipped with crash recorders to measuring frontal impacts. This paper analyses the influence of different characteristics derived from the acceleration time history on the risk of short- and long-term disability to the neck in frontal impacts. The study includes injury outcomes from 187 restrained front seat occupants in 143 frontal collisions with an overlap exceeding 25%, where the crash pulses have been recorded using crash pulse recorders. The results show that the shape of the crash pulse influences the risk of long-term disability to the neck. The vehicle accelerations in the mid and last third of the crash pulse seem to be important. It is also shown how change of velocity and mean and peak accelerations influence the neck-injury risk. It is suggested that the risk of sustaining an AIS1 neck injury in frontal impacts could be reduced by using more effective pretensioners and more advanced belt-load limiters. These results may also have implications for neck injury mechanisms in rear-end impacts.

Acceleration↗
PubMed2000

Is a lifetime history of neck injury in a traffic collision associated with prevalent neck pain, headache and depressive symptomatology?

The objective of this study is to determine whether independent associations exist between a history of neck injury related to a motor vehicle collision and: (1) graded neck pain in the past 6 months; (2) headaches in the past 6 months and; (3) depressive symptomatology during the past week. We used data from the Saskatchewan Health and Back Pain Survey, a population-based cross-sectional survey mailed to a stratified random sample of 2184 Saskatchewan adults aged 20-69 years. Fifty-five percent of the eligible population participated. The exposure was collected by asking subjects whether they had ever injured their neck in a motor vehicle collision. The outcomes: 6-month prevalence of graded neck pain, 6-month prevalence headache and depressive symptomatology during the past week were measured with valid and reliable questionnaires. Sixteen percent of the study sample reported a lifetime history of neck injury in a traffic collision. The association between neck injury and the outcomes was determined from polytomous and binary multivariate logistic regression with adjustment for age, gender and other covariates. A history of neck injury was positively associated with low intensity/low disability neck pain (OR = 2.81; 95% CI 1.81-4.37), positively associated with high intensity/low disability neck pain (OR = 4.46; 95% CI 2.49-4.99) and with disabling neck pain (OR = 3.30; 95% CI 1.48-7.39). Similarly, we found a positive association between a history of neck injury in a motor vehicle collision and headaches that moderately/severely impact on one's health (OR = 2.09; 95% CI 1.27-3.44). No association was found between neck injury and depressive symptomatology (OR = 0.84; 95% CI 0.50-1.40). Our cross-sectional analysis suggests that neck pain and severe headaches are more prevalent in individuals with a history of neck injury from a car collision. However, the results should not be used to infer a causal relationship between whiplash and chronic neck pain and headaches.

Accidents, Traffic↗
PubMed2002

Blunt vascular neck injuries: diagnosis and outcomes of extracranial vessel injury.

BACKGROUND: Blunt vascular neck injuries (BVNIs) are rare, often occult, and potentially devastating injuries. The purpose of this study was to identify a high-risk group, which would benefit from screening. METHODS: Patients with BVNIs were identified from our trauma registry and charts were reviewed. Potential risk factors for BVNI were evaluated by univariate and multivariate logistic regression. RESULTS: Thirty-one BVNIs were identified in 22 patients. The stroke rate was 60% and the mortality rate was 25%. Univariate analysis showed Glasgow Coma Scale score < or = 8, head injury (Abbreviated Injury Scale [AIS] score > or = 3), basal skull fracture, facial injury, other neck injury, thorax injury (AIS score > or = 3), abdominal injury, and cervical spine injury to be significant (p < 0.05). The multivariate predictive model had two predictors remaining significant: thorax injury (AIS [thorax] score > or = 3) and Glasgow Coma Scale score < or = 8. CONCLUSION: Screening should be undertaken for patients at increased risk for BVNI: those with risk factors identified in our regression analysis and factors previously reported.

Adult↗
PubMed2000

Penetrating neck injuries.

Penetrating neck trauma may be managed operatively or nonoperatively, depending on precise anatomic location. Conservative management of zone II injuries is currently an issue under debate. We present a brief case report followed by a description of the current strategies for operative exploration and diagnostic maneuvers in penetrating neck injuries. Support for both expectant and operative management of zone II injuries is given. We conclude that for zone II injuries, mandatory exploration by an experienced surgeon is a safe approach and that conservative management must be undertaken with extreme caution.

Adult↗
PubMed2000

Is routine arteriography mandatory for penetrating injury to zone 1 of the neck? Zone 1 Penetrating Neck Injury Study Group.

OBJECTIVE: Surgical dogma dictates that the evaluation of all penetrating zone 1 neck injuries must include arteriography to reliably exclude arterial injury requiring operation. This study was done to determine whether patients with normal findings at physical examination (PE) and on chest radiographs (CXR) really do require arteriography to identify occult, surgically important arterial injuries. METHODS: All penetrating zone 1 neck injuries in five Level I trauma centers over a 10-year period were reviewed retrospectively. Data collected included demographics, results of PE, CXR findings, other diagnostic studies done, injuries identified, need for operation, and operative findings. Arterial injury was defined as any injury to the aorta or brachiocephalic, subclavian, vertebral, or carotid arteries found on arteriography, duplex, or at operation. RESULTS: Of 138 patients studied, there were 28 arterial injuries. Of the total group of 138 patients, 36 patients had normal findings at PE and on CXR. None of these 36 patients had an arterial injury. The negative predictive value of normal PE and CXR together is 100% in this series. CONCLUSIONS: Patients with penetrating wounds to zone I who have no evidence of vascular injury on PE and who have normal findings on CXR may not require routine arteriography. Further study is needed to confirm these findings.

Adult↗
PubMed1998

Neurological sequelae of minor head and neck injuries.

The objective was to determine why some people who are involved in minor motor vehicle accidents, without loss of consciousness, have persisting headaches and neckache, and to suggest management of these symptoms. Between 1954 and 1994, over 4400 cases were referred for medico-legal opinions. A group has been selected for discussion. During the period 1954-1966, 414 cases following closed head injuries were seen with varying periods of post traumatic amnesia (PTA) from nil to greater than 72 h. The average time between the accident and the examination was 21 months. The shortest period was 3 months and the longest 7 years. The age at the time of the accident varied from 2.5 to 72 years. The largest group fell between the ages of 20 and 40 years. The main complaints were headache, giddiness, loss of concentration and poor memory. 380 were reviewed by questionnaire after settlement of the case. 112 cases of extension/flexion injuries of the neck were seen between 1985 and 1989 and their symptoms and resolution were compared with 50 cases seen over the same period following significant head or neck injury. The results showed that the more severe the head or neck injury, the less likely were the cases to suffer symptoms of post-traumatic headaches or persisting neck symptoms. In conclusion, while 70% of minor head and neck injuries settle within a few weeks of a motor vehicle accident, about 30% continue to complain of headaches and/or neck pain. The prolonged management, extensive physiotherapy and slow court settlement lead to excessive introspection and prolongation of symptoms.

Accidents, Traffic↗
PubMed2000

Report investigating the importance of head restraint positioning in reducing neck injury in rear impact.

Neck injury resulting from rear impact (often known as whiplash) is a serious cause of road trauma. It is often underestimated or overlooked because such injuries are minor on traditional injury scales but can result in long term pain and disability. The paper begins with a brief review of research into head restraints and whiplash done so far. A review of international head restraint regulations revealed the absence of any horizontal offset requirements. A review of seat strength requirements and testing procedures showed that a regulation that required a collapsible seat would involve significant compliance testing. This paper concludes a preliminary project conducted by the Federal Office of Road Safety (FORS) where the head restraints for twenty Australian market vehicles were assessed using known performance criteria. A key finding of the report was that most of the vehicles allowed for vertical adjustment of the head restraint. Also important was that none of the vehicles measured allowed horizontal adjustment and on some of the head restraints the horizontal displacement increased as the vertical height increased. As the understanding of neck injury mechanisms in rear impact develops, there may be some scope for FORS to facilitate the improvement of these standards. Further research into neck injury mechanisms may reveal yielding seat backs or new 'active' head restraint technology as a more effective countermeasure. In the meantime, educating occupants to correctly adjust their head restraints seems to be an effective way to reduce injuries in existing vehicles.

Accidents, Traffic↗
PubMed2006

Neck injury tolerance under inertial loads in side impacts.

Neck injury remains a major issue in road safety. Current side impact dummies and side impact crashworthiness assessments do not assess the risk of neck injury. These assessments are limited by biofidelity and knowledge regarding neck injury criteria and tolerance levels in side impacts. Side impact tests with PMHS were performed at the Heidelberg University in the 1980s and 1990s to improve primarily the understanding of trunk dynamics, injury mechanisms and criteria. In order to contribute to the definition of human tolerances at neck level, this study presents an analysis of the head/neck biomechanical parameters that were measured in these tests and their relationship to neck injury severity. Data from 15 impact tests were analysed. Head accelerations, and neck forces and moments were calculated from 9-accelerometer array head data, X-rays and anthropometric data. Statistically significant relationships were observed between resultant head acceleration and neck force and neck injury severity. The average resultant head acceleration for AIS 2 neck injuries was 112 g, while resultant neck force was 4925 N and moment 241 Nm. The data compared well to other test data on cadavers and volunteers. It is hoped that the paper will assist in the understanding of neck injuries and the development of tolerance criteria.

Abbreviated Injury Scale↗
PubMed1986

Neck injuries in football players.

Understanding neck injuries in football players starts with understanding how the game is played--not the strategy, but the training techniques and requirements of the game. Neck injuries are an unavoidable part of the game. What can be improved are the preventative measures, the treatment techniques, and some standardization of risk factors in playing after a neck injury. Prevention starts with decreasing the use of the head as an offensive weapon and with proper shoulder pads. Treatment begins with proper on-field evaluation and transportation techniques and is completed by good consultation services. Proper evaluation of risk demands open discussions with the patient of all factors involved. Clear advice is given to players and to the team through their medical staff.

Adolescent↗
PubMed2003

Neck injuries among the elderly in Sweden.

Neck injuries are some of the most important injuries as they have the potential to influence the spinal cord. A previous national survey of neck injuries in Sweden revealed that injury incidence was increasing for the population over 65 years of age, although it was decreasing for the population as a whole. The aim of this study was therefore to further clarify the magnitude, severity, and external causes of neck injuries in the elderly people in Sweden. A national incidence study, with focus on the age group above 65 years, was undertaken with data from the injury surveillance program at the Swedish National Board of Health and Welfare. The investigation includes cervical vertebral fractures reported between 1987 and 1999, and cervical soft tissue injuries from 1997 to 1999. Data in the hospital discharge register were reported in ICD9 from 1987 to 1996, while data from 1997 to 1999 were reported in ICD10. During the study period 4168 cervical injuries occurred of which 341 were fatal. People above 65 years of age made up 17% of the population and sustained 30% of all cervical injuries and 43% of all fatal cervical injuries. Half of the cervical injuries were axis (C2) fractures. Lower vertebral fractures occurred in 16% of the cases and atlas (C1) fractures in 11%. The cervical soft tissue injuries amount to 19% of all injuries. Fall accidents account for the majority (71%) of the accidents. There is an increasing trend for fall accidents resulting in neck injuries. The male population has a higher incidence for neck fractures than females, disregarding the external cause of injury. The upper cervical injuries are the most common, have the longest hospital treatments, and seem to be caused mainly by low energy falls. Further research is needed to understand the mechanisms of these injuries and in this aspect engineering could contribute with valuable knowledge, through accident simulations with numerical models. The increasing incidence of fall injuries calls for further preventive actions. The public sector should implement preventive strategies to reduce the number of extrinsic accidents, while the health care sector should focus on preventing intrinsic accidents with individual actions for each patients.

Accidental Falls↗
PubMed1991

[Penetrating neck injuries].

The frequency of penetrating neck injuries has increased in recent years. In 16 patients with such injuries treated during the past 2 years, neck exploration was performed immediately. In 4 there was destruction of the throat or trachea, in 3 a tear in the esophagus, in 1 a tear in the hypopharynx and in 1 a tear in the submandibular region penetrating the floor of the mouth. In 8 there was no damage to the neck organs. Of the 16, 1 died on the operating table from hemorrhage from multiple tears of the hypopharynx, the esophagus and the thyroid gland. 2 different approaches are used in dealing with penetrating neck injuries: immediate exploration, or the use of imaging methods to diagnose the degree of damage, followed by close supervision. In the light of our experience we advocate immediate neck exploration.

Humans↗
PubMed1995

Laryngotracheal disruption from blunt pediatric neck injuries: impact of early recognition and intervention on outcome.

Blunt and penetrating neck injuries are an infrequent cause of morbidity and mortality in the pediatric population. Although less common than penetrating injuries, blunt pediatric neck injuries are more often life-threatening because of associated laryngotracheal disruption. The authors reviewed their experience with pediatric neck injuries over the past 5 years. There were nine blunt and 14 penetrating injuries, representing 0.5% of the trauma admissions. There was no significant difference in age or gender distribution between the two groups. Blunt pediatric neck injuries were more often associated with frank respiratory distress at the time of presentation. Massive subcutaneous emphysema and hoarseness were the most common symptoms encountered. All patients with blunt injury underwent direct laryngoscopy and bronchoscopy (DL & B) and esophagoscopy. DL & B results were positive for eight patients; seven patients underwent neck exploration and successful repair of the laryngotracheal injuries. There were two deaths; one of these patients had laryngeal transection, which was not recognized at the time of DL & B. The other death resulted from associated tracheobronchial disruption secondary to massive blunt chest trauma. The patients with penetrating neck injuries were more likely to be treated nonoperatively, to have a shorter stay in the hospital and intensive care unit, and to have a lower injury severity score. There were no deaths in this group. The authors conclude that all patients with blunt neck trauma should undergo emergent and meticulous DL & B. Visualization of laryngotracheal disruption mandates immediate neck exploration and primary repair.

Adolescent↗