Varied presentations, magnitude, and outcome of traumatic neck injuries at a level I trauma center

Abstract

Introduction:Traumatic neck injuries (TNIs) constitute 5%–10% of all trauma cases. These injuries can be caused by either penetrating or blunt trauma. Patients can have a varied presentation like cut injury over the neck, bleeding, neck swelling, breathing difficulty, dysphagia, etc.Methods:This was a retrospective observational study conducted at a level I trauma center in India from January 2016 to March 2020. One hundred thirty patients who required admission and intervention due to TNIs were included in this study.Results:One hundred thirty patients with neck injuries were included in this study. Males were predominant (91.5%) with the age ranging from 10 to 70 years. The most common mechanism of injury was physical assault (40.7%), followed by road traffic injury (23.8%) and self-inflicted injuries (18.4%). Penetrating trauma was predominant. Open neck wound with bleeding was the most common presenting symptom. Zone II injuries were more common (83.8%) followed by zone I (12.3%) and zone III (3.8%). Soft tissue injury including skin, platysma breach, and strap muscle injury was present in 46.9% of patients. Laryngopharyngeal injury was present in 13.8%, tracheal injury in 28.5%, vascular injury in 13.8%, and esophageal injury in 4.6% of patients.Conclusion:Penetrating neck trauma is more common than blunt in developing countries like India. Advanced Trauma Life Support (ATLS) protocol guides the initial management. The definitive management depends on the type and mechanism of injury, anatomical level, severity, and the organ injured.