Role of Conservative Management in Neck Trauma: A Case Series Study

Introduction: Given the fact that neck is a vital component of one’s anatomy, injuries of this organ may be accompanied by fatal complications. In this article, we aimed to evaluate the etiology of neck trauma, simultaneous injuries of other organs, therapeutic methods for neck trauma, associated complications, length of hospital stay, at Ghaem Hospital over 10 years. Materials & Methods: In this retrospective study, we evaluated all cases of neck trauma at Ghaem hospital during 1994-2013. Patients were allocated into two groups of blunt and penetrating injuries. Trauma zone, therapeutic methods, coexisting injuries of other organs, associated complications, length of hospital stay, and mortality rate were evaluated in these two groups. Results: In this study, 75 (75%) and 25 (25%) cases were penetrating and blunt, respectively. Overall, 45% of the subjects had other simultaneous injuries and central nervous system injury accounted for the majority of cases. Zone II of the neck was involved in 89% of penetrating neck injuries and 70% of these subjects underwent surgery; conservative management was applied for 30% of the cases. Mortality rate was estimated at 3% for penetrating neck injuries and mean length of hospital stay time was 6±2 days. Moreover, 68% of blunt neck injuries were explored. The most common cause of surgery was vascular exploration (68%) and the most common surgical intervention was vein ligation (64%). Mortality rate for blunt neck injuries was estimated at 5.2%, and mean mortality rate was 3.5% in both groups. Conclusion: Considering the severity of complications associated with neck injuries, early neck exploration is suggested for unstable cases or individuals with injuries deeper than the platysma. In addition, the role of diagnostic techniques such as helical computed tomography and interventional angiography was emphasized in the current study.