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[Neck injuries].

L Rosén1, J A Weigelt, K L Mattox

  • 1Haerens Sanitet, Lahaugmoen, Skjetten.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|April 10, 1992
PubMed
Summary
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The diagnostic approach for neck injuries prioritizes patient stability and wound location. Stable patients undergo selective imaging, while unstable patients require immediate surgery for critical neck trauma.

Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Anatomy

Context:

  • Neck injuries present complex diagnostic challenges.
  • Management strategies vary based on patient stability and wound characteristics.
  • Anatomical zones of the neck dictate specific diagnostic pathways.

Purpose:

  • To outline an evidence-based diagnostic work-up for neck injuries.
  • To differentiate management protocols for stable versus unstable patients.
  • To guide surgical exploration and diagnostic imaging selection based on injury location.

Summary:

  • Hemodynamically unstable patients with active bleeding or respiratory distress require immediate surgical intervention.
  • Stable patients undergo selective diagnostic work-up, including angiography for Zone I and Zone III injuries.

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  • Routine exploration is recommended for Zone II injuries, with selective imaging as an alternative.
  • Carotid artery repair is indicated for focal or no neurological deficits.
  • Esophageal and tracheal injuries are primarily repaired.

    • Impact:

    • Optimizes patient outcomes by tailoring diagnostic and treatment strategies.
    • Reduces unnecessary surgical morbidity associated with routine exploration.
    • Provides a clear framework for managing diverse neck trauma presentations.
    • Highlights the importance of anatomical zoning in trauma management.