Journal of Trauma and Injury

The voice of injury: a case report of isolated trauma to the larynx: Najeebuddin Mohammed, Ashima Sharma, Alekhya Machani, Sujata Patnaik; J Trauma Inj. 2026;39(1):85-89. Published online March 31, 2026; DOI: https://doi.org/10.20408/jti.2025.0065

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Abstract PDF: Although uncommon, laryngotracheal injuries carry a significant risk of mortality. This rare case of isolated laryngeal injury underscores the importance of recognizing the various potential presentations of such injuries and highlights the evidence-based management strategies that every emergency physician should consider when treating potential airway trauma. A 45-year-old male motorcyclist was involved in a road traffic accident during the night and presented to the emergency department the following morning. The patient complained of breathlessness, neck pain, hoarseness of voice, and noisy breathing. Examination revealed stridor, swelling in zones 1 and 2 of the neck, tenderness over the thyroid, and subcutaneous emphysema over the neck and anterior chest. A definitive airway was secured, and computed tomography imaging revealed a fracture of the thyroid cartilage. The patient was managed conservatively, extubated after 1 week, and discharged after 2 days of observation. Classification of the type of injury and the use of an algorithmic approach, involving consensus among the emergency department, trauma surgeons, and the critical care team, can help streamline and standardize management of these cases. Furthermore, a thorough understanding of the dos and don’ts in securing the airway in patients with laryngotracheal injuries increases the robustness of the approach to managing this patient population.; Summary

A large foreign body removal from the anterior mediastinum using a minimally invasive method after a shrapnel wound to the neck: a case report: Igor Lurin, Eduard Khoroshun, Vitaliy Makarov, Volodymyr Nehoduyko, Hannah B. Wild, Serhiy Tertishny, Yuriy Bunin; Received April 3, 2025 Accepted July 29, 2025 Published online March 3, 2026; DOI: https://doi.org/10.20408/jti.2025.0077 [Epub ahead of print]

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Abstract PDF: This case report describes the diagnosis and surgical management of a shrapnel wound to the neck with a retained foreign body (metal fragment) in the anterior mediastinum. A 44-year-old male service member was wounded in the neck during an air raid. Thirty minutes after sustaining the injury, the patient reached a forward surgical team, exhibiting hemodynamic instability responsive to resuscitation. After initial stabilization, the forward team performed primary surgical treatment of the wound, including hemostasis, irrigation and debridement, and drainage. Twelve hours later, the patient was transported by ground to the Military Medical Clinical Center of the Northern Region of the Military Medical Center of the Armed Forces of Ukraine and hospitalized in the surgical department. Diagnostic evaluation included computed tomography of the head, chest, abdomen, and pelvis along with esophagogastroduodenoscopy, which demonstrated fracture of left ribs 1 and 2, a 40×15-mm metal fragment in the anterior superior mediastinum with pneumomediastinum and hemomediastinum, and metal fragments in the soft tissues of the neck without contrast extravasation. Esophagogastroduodenoscopy revealed no evidence of esophageal injury. Surgical management included left video-assisted thoracoscopic surgery with opening of the anterior mediastinum and removal of the foreign body (metal shrapnel fragment) using a magnetic surgical instrument. The patient was discharged 2 weeks postoperatively. Gunshot wounds of the neck with a large foreign body in the anterior mediastinum are rare. The use of minimally invasive surgical techniques and modern magnetic surgical instruments can reduce surgical morbidity and may be used at tertiary care centers.; Summary

The SPAIRE (saving piriformis and internus, repair of externus) posterolateral approach in bipolar hemiarthroplasty for femoral neck fractures: a case report: Nazim Sifi, Sorin Suba; J Trauma Inj. 2025;38(3):268-272. Published online March 25, 2025; DOI: https://doi.org/10.20408/jti.2024.0099

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Abstract PDF: Femoral neck fractures commonly occur in older patients and typically require surgical intervention to promptly restore mobility and minimize complications. While the anterior, lateral, and posterior approaches are frequently employed for hemiarthroplasty, each has its own benefits and drawbacks. Notably, the posterior approach has been linked to a higher risk of dislocation in some studies. The SPAIRE (saving piriformis and internus, repair of externus) technique is a modern adaptation of the traditional posterolateral approach. This less invasive, anatomically considerate method preserves the piriformis muscle tendon and the conjoint tendon of the superior gemellus, obturator internus, and inferior gemellus muscles. However, it involves sectioning the tendon of the obturator externus muscle. The technique is designed to maintain stabilizing muscular structures, decrease dislocation risk, and hasten functional recovery, including in patients with neurological conditions. This case report describes the treatment of a 79-year-old woman with a transcervical fracture of the right femoral neck. A bipolar hemiarthroplasty was performed using the SPAIRE technique. The procedure effectively preserved the functional synergistic unit of the piriformis-conjoint tendon (quadriceps coxa) and included meticulous capsular and tendinous repair. The patient's postoperative recovery was characterized by an excellent functional outcome at the 3-month follow-up. This case highlights the advantages of the SPAIRE technique in enhancing joint stability and facilitating rapid recovery, especially in geriatric patients.; Summary

A step-by-step intraoperative strategy during one-stage reconstruction of an acute electrical burn injury in the neck for superior surgical outcome in India: a case report: Mainak Mallik, Sanjay Kumar Giri, M. Vishnu Swaroop Reddy, Kallol Kumar Das Poddar; J Trauma Inj. 2024;37(2):151-157. Published online May 17, 2024; DOI: https://doi.org/10.20408/jti.2023.0075

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Electrical burn injuries can cause more damage than clinical evaluations initially suggest. The energy waves penetrate from the surface to the deepest layers of tissue, causing extensive harm at every level. The neck is a critical area, both functionally and aesthetically. We present a case involving a young male patient with a severe fourth-degree electrical burn on the neck, who underwent a single-stage debridement and reconstructive surgery. The pectoralis major myocutaneous flap is a versatile option for various head and neck reconstructions. However, if the donor site cannot be closed primarily and requires split-thickness skin grafting, it can result in unsightly scars and deformities. For large flap paddles, it is ideal to reconstruct the secondary defect with locoregional flaps. In this case, we successfully reconstructed the donor site's secondary defect using a contralateral internal mammary artery perforator flap, without resorting to any skin grafts. The early postoperative results demonstrated satisfactory cosmesis, patient satisfaction, and functional outcomes.

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High-Voltage Electrical Injury Causing a Full-Thickness Laryngotracheal Wall Defect: Reconstruction With an Anterolateral Thigh Free Flap and an Inverted Split-Thickness Skin Graft
Aparna Sinha, Shashank Chauhan, Nandini Singh Tanwar, Akshara Palreddy
Cureus.2026;[Epub] CrossRef

Outcomes of open neck injuries: Dongsub Noh, Jin Ho Choi; J Trauma Inj. 2022;35(3):168-172. Published online June 29, 2022; DOI: https://doi.org/10.20408/jti.2021.0056

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Purpose
The neck is a particularly critical region for penetrating injuries due to the close proximity of the trachea, esophagus, blood vessels, and the spinal cord. An open neck injury has the potential for serious morbidity and mortality. The purpose of this study is to evaluate the assessment and management of open neck injuries.
Methods
In this retrospective study, open neck injury patients who were admitted to NAME University Hospital Trauma Center between December 2015 and December 2017 were analyzed for epidemiology, the mechanism of trauma, the injured organ, complications, and mortality.
Results
Thirty-two patients presented with open neck injuries. All patients underwent computed tomographic angiography to evaluate their injuries once their vital signs stabilized. Among these patients, 27 required surgical treatment. The most commonly injured organ was the airway. There were five deaths, and the main cause of death was bleeding. Mortality was associated with the initial systolic blood pressure at the hospital and Glasgow Coma Scale.
Conclusions
Mortality from open neck injuries was associated with initial systolic blood pressure at the hospital and Glasgow Coma Scale.

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Penetrating neck trauma: a comprehensive review
Lindsey Loss, Reynold Henry, Anna White, Kazuhide Matsushima, Christopher Barrett, Daniel Lammers, Martin Schreiber, Kenji Inaba
Trauma Surgery & Acute Care Open.2025; 10(1): e001619. CrossRef
Penetrating Neck Injury: A Case Report and Review of Management
Chandu Raj B, Madhur Uniyal, Arun Varghese, Nilesh Y Jagne, Deepika Kandpal
Cureus.2025;[Epub] CrossRef

Successful management of a common carotid artery injury using a Pruitt-F3 Carotid Shunt: a case report: Kang Kook Choi, Jayun Cho, Min A Lee, Soo Min Eun, Yang Bin Jeon; J Trauma Inj. 2022;35(Suppl 1):S3-S7. Published online May 25, 2022; DOI: https://doi.org/10.20408/jti.2021.0032

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Penetrating neck injuries are a surgical challenge. In particular, penetrating neck injuries associated with carotid artery injuries have a high mortality rate. Overt external hemorrhage is unanimously considered as an indication for surgical exploration. The authors present a case of successful surgical management for a penetrating common carotid artery injury using a Pruitt-F3 Carotid Shunt (LeMaitre Vascular Inc., Burlington, MA, USA) in a 60-year-old male patient who was transferred to the level 1 trauma center due to a metal fragment piercing his neck while working. Active pulsatile bleeding was observed from the 3-cm-long external wound on the anterior neck in zone II. Emergent neck exploration showed near-total transection of the left common carotid artery just below the carotid bifurcation. After a Pruitt-F3 Carotid Shunt was applied to the injured carotid artery as a temporary vascular shunt, artificial graft interposition was performed for the injured common carotid artery. The patient experienced cerebral infarction as a complication caused by ischemia-reperfusion of the common carotid artery but was discharged in a suitable state for rehabilitation therapy.

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Damage Control Surgery for Wartime Carotid Artery Injuries: Interaction Between Role 2 and Role 3 Facilities in Ukraine and a Clinical Case Series Analysis
Ihor Rusanov, Dmytro Mialkovskyi, Iurii Mikheiev, Roman Kuziv, Kostiantyn Gumeniuk, Serhii Machuskyi, Alex Valadka, Rocco A. Armonda
EJVES Vascular Forum.2026; 65: 107. CrossRef
One-Stage Endovascular-to-Open Repair for Traumatic Common Carotid Artery (CCA) Pseudoaneurysm: Expanding the Hybrid Treatment Landscape
Alexander T Daskalov, Boris Ilchev
Cureus.2025;[Epub] CrossRef

A case report of “minor” trauma leading to a major disability: whiplash-associated dysphagia, dysphonia, and dysgeusia: Ami Schattner, Yair Glick; J Trauma Inj. 2022;35(2):115-117. Published online May 19, 2022; DOI: https://doi.org/10.20408/jti.2021.0043

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“Whiplash”-type injuries are commonly encountered and often cause neck pain, neck stiffness, and headaches. However, these injuries can have rare and poorly recognized complications, such as the development of a prevertebral hematoma leading to acute respiratory failure in the emergency department, followed by severe, life-threatening dysphagia and recurrent aspirations. In the patient described herein, a whiplash injury was accompanied by vocal cord paralysis and dysphonia (vagus nerve), dysgeusia (glossopharyngeal nerve, vagus nerve), and upper esophageal spasm (cricopharyngeal muscle, vagus nerve). It is unlikely that this was a complication of cervical fusion surgery. Instead, a combined stretch-induced lower cranial nerve injury, possibly on the exit of these nerves through the jugular foramen, seems to be a likely, but underappreciated mechanism occurring in rare instances of whiplash injuries.

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Isolated bilateral vocal cord paralysis without structural injury following blunt neck trauma: A case report
Amritanshu Saurabh, Milandeep, Vijay Adabala, Pranabh Kushwaha
Trauma & Case Reports.2026; 63: 101337. CrossRef
Xerostomia Following Mandibular Fracture: Investigating Potential Etiological Links
Ji-Young Lee
Journal of Oral Medicine and Pain.2025; 50(1): 41. CrossRef

Life-Threatening Necrotizing Fasciitis of the Posterior Neck: Ji-An Choi, Jung-Ha Kwak, Chung-Min Yoon; J Trauma Inj. 2020;33(4):260-263. Published online November 27, 2020; DOI: https://doi.org/10.20408/jti.2020.0025

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Necrotizing fasciitis is an infection of the subcutaneous tissue that results in destruction of the fascia and is disproportionately common in patients with chronic liver disease or diabetes. Necrotizing fasciitis of the head and neck is rare, but has a high fatality rate. A 50-year-old man with a past medical history of diabetes reported a chief complaint of a wound in the posterior neck due to trauma. The wound had grown and was accompanied by pus and redness, and the patient had a fever. When the patient was referred to department of plastic & reconstructive surgery, the sternocleidomastoid muscle, semispinalis capitis muscle, splenius capitis muscle, and trapezius muscles were exposed, and the size of the defect was about 25×20 cm. Dead tissue resection was performed before negative-pressure wound therapy, followed by a split-thickness skin graft (STSG). After a 2-week course of aseptic dressing post-STSG, the patient recovered completely. No postoperative complications were observed for 1 year. Necrotizing fasciitis is a life-threatening, rapidly spreading infection, requiring early diagnosis and active surgical treatment. In addition, broad-spectrum antibiotics are required due to the variety of types of causative bacteria. Broad necrotizing fasciitis of the posterior neck is rare, but can quickly progress into a life-threatening stage.

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Reconstruction of cervical necrotizing fasciitis defect with the modified keystone flap technique: Two case reports
Wonseok Cho, Eun A Jang, Kyu Nam Kim
World Journal of Clinical Cases.2024; 12(7): 1305. CrossRef
Posterior cervical necrotising fasciitis: a multidisciplinary endeavour in surgery
Jia Hui Lee, Fung Joon Foo, Allen Wei-Jiat Wong
Journal of Surgical Case Reports.2023;[Epub] CrossRef

Exceptionally Unusual Case of a Self-Inflicted Suicidal Cut Throat Injury: Mezhuneituo Raleng, Anant Prakash Pore, Temsula Alinger; J Trauma Inj. 2020;33(2):134-137. Published online June 5, 2020; DOI: https://doi.org/10.20408/jti.2019.043

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Abstract PDF: Here we present a 43-year-old man who was brought with a self-inflicted cut throat injury; 18 hours after the suicidal attempt. On examination a deep 12 cm cut at the level of the hyoid bone exposing the posterior pharyngeal wall was seen. Emergency surgery with primary repair, tracheostomy and feeding gastrostomy was done. Post-operative period was uneventful and patient recovered without any speech or swallowing abnormalities. Through this article we would like to stress that even in cases of frightening ghastly wounds, by maintaining simple surgical principles we can achieve good outcomes.; Summary

Clinical Analysis of the Patients with Isolated Low-Velocity Penetrating Neck Injury: Junepill Seok, Hyun Min Cho; J Trauma Inj. 2018;31(1):1-5. Published online April 30, 2018; DOI: https://doi.org/10.20408/jti.2018.31.1.1

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Abstract PDF: Purpose
Although there has been substantial progress for the treatment of thoracic trauma, the mortality of the penetrating neck injury is still high, has been reported about 10?15%. However, there has not been a report which is reflecting Korean medical present. We retrospectively analyzed the penetrating neck injury patients based on the Korean Trauma Data Base.
Methods
Between December 2013 and June 2017 at the trauma center of the Pusan National University Hospital, Busan, Korea, total of 36 patients with isolated low-velocity penetrating neck injuries were included. We analyzed the patients’ age, gender, injury mechanism and causes by medical chart review.
Results
Among total of 36 patients, 26 (72.2%) were male and 10 (27.8%) were female. Homicidal neck injuries were most common, followed by accidental and suicidal injuries (47% vs. 33% vs. 19%, respectively). All penetrating injuries in our study were low-velocity trauma such as following: knife (n=16, 44.4%); glass or glass bottle (n=11, 30.6%); scissors (n=4, 11.1%); grinder (n=2, 5.6%); and three (8.3%) of miscellaneous injuries. Twenty-seven (75.0%) patients underwent emergency surgery, and only one (2.8%) patient underwent elective surgery. Eleven (30.6) patients were diagnosed with superficial injuries, including six patients who had conservative treatment. Twelve (33.3%) patients had arterial injuries and 10 (27.8%) patients had venous injuries. The patients who had deep injuries showed significant difference against the patient with superficial injury (98.0 vs. 129.1, p=0.008).
Conclusions
Low velocity penetrating injury confined to the neck is able to be successfully treated with prompt surgical management. Regardless of the conditions which are evaluated at emergency department, all penetrating neck injury patients should be regarded as urgent surgical candidates.; Summary

Stent Graft Repair of Penetrated Injury of the Common Carotid Artery: Soon Jin Kim, Sang Woo Ryu, Jaykey Chekar, Yong Tae Kim, Bo Ra Seo; J Trauma Inj. 2016;29(4):172-175. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.172

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Penetrated injury of common carotid artery (CCA) is rare and extremely lethal. Carotid artery injury tends to bleed actively and potentially occlude the trachea. It can cause fatal neurological complications. An accurate diagnosis and adequate treatment are very needed to the successful outcome of the penetrating vascular injury in zone 1, 2, and 3 of the neck. Open surgical treatment is more invasive and complicated than endovascular treatment. We experienced a case with penetrating injury in neck zone 2. Here, we report the case successfully treated with endovascular stent graft technique.

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Hybrid Endovascular and Direct Surgical Approach for Treatment of Penetrating Common Carotid Artery Injury: A Case Report
Dai UZUKI, Ryo HIRUTA, Takao KOJIMA, Yu NARUSE, Jun SAKUMA, Hiroharu SHINJO, Takashi IGARASHI, Masazumi FUJII
NMC Case Report Journal.2024; 11: 377. CrossRef

Wound Probing in Neck Trauma Patients: Jin Bong Ye, Young Hoon Sul, Yun Su Mun, Seung Je Go, Oh Sang Kwon, Gwan Woo Ku, Min Koo Lee; J Trauma Inj. 2015;28(3):198-201. Published online September 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.3.198

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Abstract PDF: Neck trauma is a relatively uncommon but can be a life-threatening injury. Several guidelines for neck trauma is established to recommend a proper management such as no clamping of bleeding vessels, no probing of wounds, Trendelenberg position for preventing venous air embolism. Here, we present a regretful case of 49-year-old man with neck trauma presenting undesired bleeding after probing of wound, and then discuss about treatment guildeline for neck trauma with a review.; Summary

Penetrating Neck Trauma: A Case of Spinal Cord Injury by Embedded Scissor: Seon Hee Kim, Sun Woo Choi, Sung Jin Park, Kwang Hee Yeo, Chang Wan Kim, Sang Bong Lee, Ho Hyun Kim, Chan Yong Park, Jae Hun Kim, Jung Joo Hwang, Hyun Min Cho; J Trauma Inj. 2015;28(2):71-74. Published online June 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.2.71

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Abstract PDF: Penetrating neck trauma involving spinal cord injury is relatively uncommon, but can be life-threatening. We report a case of 59-year-old female who presented with hypotension after stab injury self-inflicted with a scissor to her neck. Although Open removal of the scissor and control of bleeding were successfully done, penetration of spinal cord resulted in a neurologic impairment.; Summary

Comparison between Two Kirschner Wire Fixation and Three Wire Fixation, in Treating of Metacarpal Neck Fracture Using Multiple Retrograde Kirschner Wire Fixation: Sang Ho Kwak, Young Ho Lee, Gil Joon Seo, Goo Hyun Baek; J Trauma Inj. 2015;28(2):55-59. Published online June 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.2.55

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PURPOSE
To compare clinical and radiographic outcomes of between two and three Kirschner wire(K-wire) intramedullary fixation for fractures in the neck of the metacarpal bone.
METHODS
A single institutional retrospective review identified 28 cases of metacarpal fractures between March 2010 and August 2014. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the neck of the metacarpal bone. The patient groups were divided by the number of K-wire. Outcomes were compared for range of motion of the metacarpophalangeal joint, radiographic parameters, and period until union.
RESULTS
The fractures were treated with either 2 Kirschner wire fixation (n=10) or 3 Kirschner wire fixation (n=18). The active range of motion of metacarpophalangeal joint and radiographic result showed no statistically significant difference between the two groups. The mean union period was 5.9 weeks. However, four cases suffered distal head perforation in 2 K-wire fixation group and one case in 3 K-wire fixation group.
CONCLUSION
Multiple retrograde intramedullary Kirschner wire fixation is a good treatment of choice for fractures in the neck of the metacarpal bone. To prevent metacarpal head perforation, it is preferred to use three K-wires than two K-wires.

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Factors affecting healing following percutaneous intramedullary fixation of metacarpal fractures
Chul-Ho Kim, Dong Hwan Kim, Han-Vit Kang, Won Jun Kim, Minkyu Shin, Ji Wan Kim
Medicine.2021; 100(50): e27968. CrossRef

Emergency Repair Using Cervico-median Sternotomy for Cervicothoracic Penetrating Injury: Hyun Joo Lee, Hyun Koo Kim, Young Ho Choi; J Korean Soc Traumatol. 2008;21(2):136-139.

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Abstract PDF: A great variety of penetrating injuries is happening due to the increasing population and violence today. An optimal surgical approach is the key factor for successful repair of a complicated penetrating injury. A 23-yearold woman fell down the stairs from the second floor and received cervico-thoracic penetration injury due to a metalic bar. The metalic bar ruptured the right jugular vein and penetrated the left upper and lower lung. Under cervico-median sternotomy, neck vessels were repaired and the left thorax was successfully entered to repair the damaged lung through the mediastinal pleura. With this approach, the patient's position did not need to be changed during operation, while reduced the operation time compared to the conventional approach (cervical incision and standard thoracotomy).; Summary

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