Blunt assault: 'million dollar baby'

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.