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Neck Injury

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Ryan's Ballistic Trauma

Abstract

“Go for the throat!” “He went straight for the jugular.” Such colloquialisms demonstrate even the layperson’s appreciation for the vulnerability of the neck. The management of a firearm injury to this area requires an understanding of the trajectory, wound location, and a thorough three-dimensional understanding of the relevant anatomy.1 Over the last 20 years, trauma surgeons have embraced selective, non-operative management and damage control principles to the severely injured patient. With these new approaches have come dramatic changes in the management algorithms for penetrating neck injuries as well. Prior to this time, mandatory exploration for penetrating neck injuries was deemed standard of care.2 In the early 1980s, high volume institutions, with considerable experience in firearm injuries, began reporting the selective, non-operative management of patients with Zone II wounds presenting without evidence of vascular or aero-digestive injuries.3 Several studies over the last decade supported the non-operative approach of these patients after an appropriate diagnostic evaluation had excluded injury.4,5 More recently, some authors have applied this approach to Zone I as well.6 With continually improving advances in technology such as helical computerized tomography (CT) and interventional radiology (IR), there exist many options for dealing with specific injuries to the neck.

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Author information

Authors and Affiliations

  1. Department of Surgery and Center for Translational Injury Research, University of Texas Health Science Center, Houston, Texas, USA

    Bryan A. Cotton

Authors
  1. Matthew J. Borkon
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  2. Bryan A. Cotton
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Editor information

Editors and Affiliations

  1. Dept. Surgery, Div. Traumatology &, University of Pennsylvania Medical Ctr., Spruce St. 3400, Philadelphia, 19104, Pennsylvania, USA

    Adam J. Brooks

  2. , Academic Department of Military Surgery, Frimley Park Foundation Trust, Surrey, GU16 7UJ, United Kingdom

    Jon Clasper

  3. Royal Centre for Defence Medicine, Institute of Research & Development, Acad. Dept. of Military Surgery & Trauma, Vincent Drive, Birmingham, B15 2SQ, United Kingdom

    Mark Midwinter

  4. Birmingham Research Park, Acad. Dept. of Military Emergency Med., Vincent Drive, Birmingham, B15 2SQ, United Kingdom

    Timothy J. Hodgetts

  5. Inst. Research & Development, Dept. Military Anaesthesia, Royal Centre for Defence Medicine, Vincent Drive, Edgbaston, Birmingham, B15 2SQ, United Kingdom

    Peter F. Mahoney

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© 2011 Springer London

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Borkon, M.J., Cotton, B.A. (2011). Neck Injury. In: Brooks, A., Clasper, J., Midwinter, M., Hodgetts, T., Mahoney, P. (eds) Ryan's Ballistic Trauma. Springer, London. https://doi.org/10.1007/978-1-84882-124-8_28

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  • DOI: https://doi.org/10.1007/978-1-84882-124-8_28

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-123-1

  • Online ISBN: 978-1-84882-124-8

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