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PubMed2003

Snowblading injuries in Eastern Canada.

OBJECTIVES: To evaluate injury patterns of snowbladers and compare them with those of skiers and snowboarders. To determine possible effects of helmet use in these sports on injury to the head and neck. METHODS: This prospective case series observational study was conducted by collecting the injury reports from the ski patrol during the 1999-2000 season at Mont Tremblant ski resort, Quebec. All participants in downhill winter sports who presented themselves to the ski patrol with traumatic injury related to their sport were included. A concussion was defined as any loss of consciousness, amnesia, confusion, disorientation, vertigo, or headache that resulted from injury. The ski patroller reported helmet use on the accident report at the time of injury. RESULTS: Snowbladers present with a unique pattern of injury compared with skiers and snowboarders. The incidence of leg, knee, and ankle/foot injuries were 20.5%, 25.6%, and 10.3% respectively. Concussions represented 11% of all injuries. There was no increase in other injury, including neck injury, related to helmet use. CONCLUSIONS: Unique injury patterns in snowbladers warrant reconsideration of equipment design. Concussion is a common injury on the ski slope. Although the effects of helmet use on concussion rate are inconclusive based on this study, helmet use did not increase the rate of neck injury, even when adjusted for age.

Adolescent↗
PubMed1994

Snowmobile traumas in Finnish Lapland: injuries to head, face and neck. Possible effects of speed and the use of helmet.

In a still continuing prospective study, the possible effects of the speed of the vehicle and/or the use of helmet on the incidence of injuries to the head, face and neck were studied. The present study population comprises 223 victims of snowmobile injuries transported to one of the three hospitals in Finnish Lapland since January 1, 1991. All information was acquired from the victim or relatives on admission. The speed of the vehicle on the occasion of the accident was reported to be < 40 kmph in 48%, 40-90 kmph in 44% and > or = 90 kmph in 8% of the cases. Use of a protective helmet was reported in 65% of the accidents. Trauma to the head, face and/or neck occurred in 33/223 accidents, i.e. 15%. The speed was in the two highest categories in eight of the nine cases with neck injuries; six patients were reported to have used a helmet. Injuries to the face seemed to occur at lower speed; 11 of the 13 injuries were in the two lower categories, while seven victims did not use a helmet. Head injuries occurred in 11 cases with the speed poorly reported. A helmet was used by only four of the 11 victims. In conclusion, the helmet seems to protect from head injury, but its effect seems controversial in neck injury. The reported helmet use is high in Finnish Lapland.

Accidents↗
PubMed1993

Adolescent Head and Neck Trauma.

Head injuries in adolescents, which often result from motor vehicle accidents, sports injuries, falls, burns, or trauma due to violence, may range from mild to severe to fatal. One of the most useful initial scoring systems is the Glasgow Coma Scale. Proper care of the injured adolescent begins at the scene of the incident, with an emphasis on management of the airways, breathing, and circulation (the ABCs) and prevention of secondary injury, which may result from hypoxia, hypercarbia, rapid swings in blood pressure, hypovolemia, seizures, and poor or improper immobilization. Monitoring and management of intracranial pressure become a priority on arrival at the emergency department. Imaging techniques, such as CT scan, may be necessary. Injuries to the neck (cervical spine), which may result in quadriplegia, should be suspected in the presence of neurologic deficits.

Journal Article↗
PubMed2004

Isolated contralateral vertebral artery injury in a stab wound to the neck.

Ipsilateral vertebral artery injuries are a rare entity following trauma to the neck. We discuss the first case of an isolated right vertebral artery injury in a patient with a left stab wound. The patient required bilateral neck explorations and, due to massive bleeding, a median sternotomy in order to obtain control of the proximal segment of the right vertebral artery. We emphasize the importance for trauma surgeons to be familiar with basic but important vascular exposures. The anatomy, surgical exposure, and management of these rare injuries are discussed.

Adult↗
PubMed2004

Into hot water head first: distribution of intentional and unintentional immersion burns.

INTRODUCTION: Experience with several, previously unreported, intentional face-first immersion burns led us to evaluate the distribution of inflicted and unintentional immersion scald burns in a hospital series. SETTING: (1) Authors' clinical and legal practices; (2) Burn center at regional Level 1 trauma hospital. SUBJECTS: : (1) Case series of face-first, inflicted immersion burn victims; (2) Consecutive hospitalized scald burn victims younger than 5 years old, 1/3/1996 to 3/25/2000. METHODS: (1) Individual case reports; (2) Retrospective records review. Simple descriptive statistics, Fisher Exact test and t test. RESULTS: (1) Six cases of inflicted head and neck immersion injury are described. Four were tap water and 2 food/drink scalds. (2) 22/195 hospitalized victims had sustained immersion burns, 13 from tap water and 9 from other fluids. Six (46%) tap water immersions and no (0%) other immersions had inflicted injuries (P = 0.05). Two of the tap water immersions and one other source immersion included burning of the head and neck. Of these, one tap water immersion, but no other immersion, was inflicted. In no patients were head and neck injuries the sole or predominant site of scalding. In all, 9 children sustained inflicted scalds. Bilateral lower extremity tap water immersion scalds occurred in 100% (6/6) of abusive and 29% (2/7) of unintentional injuries (P = 0.02). Buttock and perineal injuries occurred in 67% (4/6) inflicted versus 29% (2/7) unintentional tap water immersion scalds (P = 0.28). Other fluids caused bilateral lower extremity immersion burns in 3/9 (33 %) unintentionally injured patients, but no abused children (NS). CONCLUSIONS: Craniofacial immersion injury, although seen by the authors in legal cases, is infrequent. It was present incidentally in one inflicted tap water burn in the consecutive hospital series. This series affirms the predominance of bilateral lower extremity burns in inflicted tap water immersions. Buttock/perineal immersions were more common with abuse than with unintentional injury.

Accidents, Home↗
PubMed2005

Mammalian bite injuries to the head and neck region.

OBJECTIVE: To determine the frequency and presentation of mammalian bite injuries to the head and neck region seen in a plastic surgery unit. DESIGN: Observational study. PATIENTS AND DURATION OF STUDY: The Plastic and Reconstructive Surgery Unit, PGMI, HMC, Peshawar from July 1999 to June 2003. PATIENTS AND METHODS: During the study period 40 patients presented with mammalian bite injuries to the head and neck region. Information about patient's demographics, biting animal, circumstances of sustaining injury, duration of injury, location and extent of injury, treatment administered, cosmetic outcome and complications were noted. RESULTS: The mammalian bite injuries accounted for 10% of patients managed within the study period for soft tissue injuries to the orofacial region. Among the 40 cases studied, 3 patients were females and 37 were males. Age ranged from 2.5 years to 71 years with the mean of 23 years. The duration of injury varied from 1 hour to 1 year (median 3+2 days). Mammals implicated were humans, dogs, horse, donkey, bear and wolf. All of the 40 patients presented with head and neck injury. Auricular injury was seen in 10 patients, lip injuries in 10 patients, nasal injuries in 10 patients, cheek injuries in 6 patients and scalp injuries in 4 patients. In 70% (28) of cases avulsion of tissue (type-III) was noted. Patients presenting earlier for treatment achieved better cosmesis than the patients presenting late in the course of their injury. CONCLUSION: Mammalian bite injuries to the head and neck region can result in facial disfigurement with distressing physical and psychological consequences. Early management of such complex injuries usually guarantees satisfactory outcome.

Adolescent↗
PubMed2001

Headache, neck pain, and neck mobility after acute whiplash injury: a prospective study.

STUDY DESIGN: A 6-month prospective study of neck mobility in patients with acute whiplash injury and a control group with acute ankle distortion was conducted. OBJECTIVES: To assess active neck mobility after acute whiplash and ankle distortion injuries, and to relate neck mobility to headache, neck pain, and speed of car at the time of collision. SUMMARY OF BACKGROUND DATA: A major problem after whiplash injury is restriction of neck mobility immediately subsequent to trauma. It is, however, unclear whether neck mobility changes after the acute injury are related to the associated headache and neck pain. METHODS: Cervical range of neck motion, neck pain, and headache were assessed after 1 week, then 1, 3, and 6 months after injury in 141 patients with acute whiplash injury, and in 40 patients with acute nonsport ankle distortion. RESULTS: Patients with whiplash injury had significantly reduced flexion, extension, lateral flexion, and rotation of the neck immediately after injury, as compared with patients with ankle distortion injury. Neck mobility, however, was similar in the two groups after 3 months. In patients with whiplash injury, neck pain and neck mobility were found to be related inversely to reported headache and neck mobility. Neck mobility was not significantly related to a difference in car speed at the time of collision. CONCLUSIONS: Neck mobility is reduced immediately after, but not 3 months after, a whiplash trauma. Headache and neck mobility are related inversely and neck pain and neck mobility are related inversely during the first 6 months after acute whiplash injury.

Acute Disease↗
PubMedDate not supplied

Chronic repetitive unrecognized flexion injury of the cervical spine (high jumper's neck).

Unrecognized flexion injuries of the cervical spine may lead to late instability and neurologic damage. These hidden flexion injuries may be from acute or chronic traumatic episodes. Cervical spine instability was seen in an amateur high jumper as a result of chronic repetitive flexion loading of her cervical spine due to incorrect landing technique. The instability from these types of flexion injuries is generally unrecognized on a routine lateral radiograph. The presence of slight anterior subluxation, simple compression fractures, or subtle kyphotic angulation at one cervical level should alert the physician to this diagnosis. Flexion extension views are useful to demonstrate this instability. Occupations and sports which involve repetitive flexion stress to the cervical spine are at risk for this type of late instability. Therefore, in high jumping careful attention to safe techniques of landing is of utmost importance.

Adolescent↗
PubMed1995

[Penetrating injury of the head, neck and chest by a nail-gun: a case report].

A very rare case of directly penetrating injury of the head, neck and chest caused by a nail-gun was reported. A 56-year-old male was admitted to our critical care center due to chest injury. On admission, he showed numbness of the hand & leg, left hemiparesis and hypalgesia. Physical examination disclosed three nails on the left anterior chest, but other wounds or nails were not found. Chest films showed three nails penetrating the lung without reaching the heart, but other nails were found by skull and neck films. One nail had penetrated the cervical canal at the C1 level through the posterolateral cervical region. Two other nails were demonstrated at the right temporal and the left frontal region, Computed tomography revealed no massive cerebral hemorrhage and cerebral angiography showed no extravasation and no passage through main vessels. Emergency surgery was performed uneventfully and the nails in the chest, neck and head were totally removed. He was discharged one month after surgery. Some injuries caused by a nail-gun have been reported in the world literature but in Japan this multiple injury case was the first reported. Since nail-gun injuries can cause multiple damage, systemic X-ray examination was very important.

Cervical Vertebrae↗