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Blunt assault: 'million dollar baby'

Pantelis Hadjizacharia1, Peter Rhee, Viraj Pandit

  • 1Division of Trauma, Critical Care, and Acute Care Surgery, University of Arizona, Tucson, Arizona, USA.

The American Surgeon
|January 10, 2014
PubMed

Insights

Blunt head, neck, and face assaults rarely cause cervical spine injuries, with only 0.003% of patients experiencing fractures or subluxations. Direct neck trauma is key for identifying high-risk patients needing cervical spine evaluation.

Area of Science:

  • Trauma Surgery
  • Orthopedic Surgery
  • Emergency Medicine

Background:

  • Management of blunt head, neck, and face trauma presents challenges in cervical spine clearance.
  • Existing literature shows conflicting reports on the necessity of extensive cervical spine evaluation in these patients.

Purpose of the Study:

  • To determine the incidence and risk of cervical spine injuries following blunt assault to the head, neck, and face.
  • To investigate the association between these injuries and other trauma.

Main Methods:

  • Retrospective case review of blunt assault trauma admissions to a Level I trauma center.
  • Inclusion criteria: patients assaulted with hands, feet, or blunt instruments to the head, neck, and face.
  • Identification of cervical spine fractures or subluxations.

Main Results:

  • 11 out of 3286 (0.003%) patients sustained cervical spine fractures or subluxations.
  • No cervical spinal cord injuries were reported.
  • Injuries were associated with direct blows to the cervical spine; 45% required surgical stabilization.

Conclusions:

  • Cervical spine injuries from blunt assault are rare but can be severe, necessitating surgical intervention.
  • Exhaustive cervical spine evaluation may not be required for patients without direct neck trauma.

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