Chirukandath Ravindran, Sulaiman Sumin V, Sasi Tinu, Suresh Nanditha, R Agni Vyas, Syamsundar Gopika, Kiran Mathew Antony
General Surgery, Government Medical College, Thrissur, Thrissur, IND.
Cureus. 2025 Mar 27;17(3):e81311. doi: 10.7759/cureus.81311. eCollection 2025 Mar.
Traumatic neck injuries represent a critical emergency in surgical practice due to the high concentration of vital structures within the cervical region. These injuries can be classified into blunt and penetrating types, each presenting unique challenges in diagnosis and management. While advances in trauma care have improved patient outcomes, the mortality and morbidity associated with neck injuries remain significant, especially in resource-limited settings.
A retrospective cohort study was conducted at Government Medical College, Thrissur, analyzing the patterns, management, and outcomes of traumatic neck injuries from January 2022 to December 2024. The study included patients aged 13-79 years, with data collected from medical records, trauma registers, and operative reports. Patient demographics, injury type, anatomical location, management strategies, and clinical outcomes were assessed.
A total of 72 traumatic neck injuries were reviewed, with the majority being young males (n=57, 79%). Blunt trauma (n=45, 62%) was more common than penetrating trauma (n=27, 38%), with road traffic accidents (n=32, 44%) and falls (n=20, 28%) being the leading causes of blunt injuries, while stabbing injuries accounted for most penetrating trauma (n=20, 73%). Emergency neck exploration was required in 17 cases (24%), and the overall mortality rate was seven cases (10%), primarily due to exsanguination (n=5, 67%) and vascular damage (n=2, 33%). The highest mortality was observed in penetrating Zone II injuries (n=5 deaths, 13%), often involving major vascular damage. Complications occurred in 13 survivors (18%), including wound infections (n=6, 8%), pneumonia (n=4, 5%), and neurological deficits (n=4, 5%). Night-time injuries were reported in 43 cases (60%), with a peak incidence during festive seasons and weekends, showing a significant association with alcohol consumption.
The findings align with global trends, where penetrating injuries, especially in Zone II, carry a significantly higher risk of mortality. The study underscores the importance of early airway management, rapid surgical intervention, and the role of imaging-based triage for blunt trauma cases. The association of neck trauma with alcohol consumption, especially during nighttime hours, highlights the need for targeted public health measures and enhanced trauma response.
This study provides valuable insights into the epidemiology, management strategies, and outcomes of traumatic neck injuries in a South Indian tertiary care center. The findings emphasize the critical role of early intervention, particularly in penetrating injuries involving vascular structures, and suggest that public health interventions and improved trauma care systems could optimize outcomes in this high-risk population.
由于颈部区域重要结构高度集中，创伤性颈部损伤是外科手术实践中的一种危急急症。这些损伤可分为钝器伤和穿透伤，每种损伤在诊断和处理上都有独特的挑战。尽管创伤护理的进展改善了患者的预后，但与颈部损伤相关的死亡率和发病率仍然很高，尤其是在资源有限的环境中。
在特里苏尔政府医学院进行了一项回顾性队列研究，分析2022年1月至2024年12月创伤性颈部损伤的模式、处理方法和结果。该研究纳入了年龄在13 - 79岁之间的患者，数据从病历、创伤登记册和手术报告中收集。评估了患者的人口统计学特征、损伤类型、解剖位置、处理策略和临床结果。
共回顾了72例创伤性颈部损伤病例，其中大多数是年轻男性（n = 57，79%）。钝器伤（n = 45，62%）比穿透伤（n = 27，38%）更常见，道路交通事故（n = 32，44%）和跌倒（n = 20，28%）是钝器伤的主要原因，而刺伤是大多数穿透伤的原因（n = 20，73%）。17例（24%）患者需要进行急诊颈部探查，总体死亡率为7例（10%），主要原因是失血（n = 5，67%）和血管损伤（n = 2，33%）。在穿透性Ⅱ区损伤中观察到最高死亡率（n = 5例死亡，13%），通常涉及主要血管损伤。13名幸存者出现并发症（18%），包括伤口感染（n = 6，8%）、肺炎（n = 4，5%）和神经功能缺损（n = 小4，5%）。43例（60%）患者报告为夜间受伤，在节日和周末发病率最高，显示与饮酒有显著关联。
研究结果与全球趋势一致，即穿透伤，尤其是Ⅱ区的穿透伤，死亡率风险显著更高。该研究强调了早期气道管理、快速手术干预以及基于影像学的钝器伤分诊的作用的重要性。颈部创伤与饮酒的关联，尤其是在夜间，凸显了有针对性的公共卫生措施和加强创伤应对的必要性。
本研究为印度南部三级医疗中心创伤性颈部损伤的流行病学、处理策略和结果提供了有价值的见解。研究结果强调了早期干预的关键作用，特别是在涉及血管结构的穿透伤中，并表明公共卫生干预和改善创伤护理系统可以优化这一高危人群的治疗结果。
