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Soft Tissue Neck Symptoms Following High-Energy Road Traffic Accidents

Malik, Hammad, MRCS*; Lovell, Martyn, FRCS(Orth)

doi: 10.1097/01.BRS.0000132514.33078.DA
Health Services Research
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Study Design. A single-blinded prospective study was performed into the occurrence and frequency of soft tissue neck symptoms of patients involved in high-energy road traffic accidents.

Objectives. We studied the occurrence of incidental soft tissue neck symptoms in victims of high energy (defined as those severe enough to cause major trauma leading to an injury severity score >16) vehicular collisions causing significant musculoskeletal trauma requiring operative intervention.

Summary Background Data. Whiplash is considered to be a soft tissue injury of the neck sustained by occupants of motor vehicles. Use of the term in the past had been restricted to hyperextension injuries following a rear impact, but is commonly now used for all types of impact. No relationship has been found between velocity or force of injury and incidence or outcome of whiplash. The preponderance of whiplash after relatively minor vehicular accidents, the unpredictability of who will develop chronic symptoms and the lack of clinical and radiological evidence of a pathological mechanism suggests that psychosocial variables are important factors in determining the development of persistent neck pain.

Methods. A total of 36 consecutive patients were recruited who had been involved in high-energy road traffic accidents and had chest, musculoskeletal, or abdominal injuries (ISS > 16) requiring admission for treatment, but who had no diagnosed injury of the cervical spine. Patients were asked in a nonspecific or leading manner at the time of admission and again at least 6 to 8 weeks postinjury if they had any neck symptoms, headaches, or paresthesiae.

Results. Only 2 of the patients interviewed described any whiplash symptoms. All symptoms were resolved at the time of second interview.

Conclusions. Our study demonstrates a surprisingly low incidence of neck symptoms following high-energy road traffic accidents in which patients sustained unrelated injuries requiring treatment.

We performed a single-blinded prospective study into the occurrence and frequency of soft tissue neck symptoms of patients involved in high-energy road traffic accidents. A total of 36 consecutive patients were recruited who had been involved in high-energy road traffic accidents and had an Injury Severity Score > 16 but who had no diagnosed injury of the cervical spine. Only 2 of the patients interviewed described symptoms of whiplash-associated disorder. Our study demonstrates a surprisingly low incidence of neck symptoms following high-energy road traffic accidents in which patients sustained unrelated injuries requiring treatment.

From the *Centre for Hip Surgery, Wrightington Hospital, Wigan; and †South Manchester University Hospitals Trust, Wythenshawe Hospital, Manchester, UK.

Acknowledgment date: June 16, 2003. First revision date: September 10, 2003. Second revision date: October 13, 2003. Third revision date: November 5, 2003. Acceptance date: November 17, 2003.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Hammad Malik, MRCS, 9 Woodacre, Manchester M16 8QQ, UK; E-mail: hammy.malik@man.ac.uk

© 2004 Lippincott Williams & Wilkins, Inc.