Neck Injuries: a Complex Problem in the Deployed Environment

Abstract

Evaluation and treatment of injuries to the neck has received a lot of attention over the past 20 years. New evaluation protocols and treatment recommendations have been developed. The goal of this review is to examine these strategies and evaluate their suitability for treatment of patients in a deployed setting. Studies from several large trauma centers have changed common practice with regard to both penetrating and blunt neck injuries. The requirement to explore all zone II neck injuries has largely been replaced by a selective exploration based on physical examination and imaging. Also, blunt cerebrovascular injuries, once thought to be rare, have been demonstrated to be common and treatment dramatically reduces the morbidity and mortality. Injuries to the neck are a significant problem in the deployed environment. The blast injuries that are common in Iraq and Afghanistan produce multiple injured casualties. In addition to injuries to other body regions, injuries to the neck can involve both blunt and penetrating mechanisms as well as injuries to the spinal column. The extent and outcome of these complex injuries has not been fully evaluated and would remain an area worthy of study.