[Complex fracture of the larynx caused by a horse kick].
Abstract: Every blunt laryngeal trauma requires examination by an ENT physician and may necessitate observation for a number of hours. The literature shows a heterogeneous picture regarding airway management (tracheotomy vs. intubation). Extremely violence forces such as horse kicks require a tracheotomy, as demonstrated by case studies. In such cases, a high level of responsibility lies with the emergency physician providing the initial treatment. We present the case of a 37-year-old horse trainer, who suffered a horse kick to the larynx with a complex laryngeal fracture. Intubation of the patient by the emergency physician would most probably have led to incorrect placement of the tube or complete displacement of larynx and trachea. In addition to securing a vital airway by tracheotomy, a timely reconstruction of the airways, where necessary by employing the temporary insertion of a tracheal stent, is the treatment of choice. The latter therapy should be applied within the first 6 hours following the accident.
Publication Date: 2014-10-02 PubMed ID: 25270837DOI: 10.1007/s00106-014-2913-6Google Scholar: Lookup
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Summary
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This research paper is about a case study that discusses the procedures followed to treat a 37-year-old horse trainer who suffered a serious larynx fracture due to a horse kick. The researchers emphasise the importance of the correct initial treatment in such cases and indicate tracheotomy and timely reconstruction of the airways as the preferred approach.
Study Context and Motivation
- This research paper is inspired by a real-life incident involving a horse trainer who suffered a complex larynx fracture due to a horse kick. The researchers aim to provide insights on the correct initial treatment needed in such cases to avoid complications.
Nature of Injuries Involved
- The nature of injuries in such cases is usually very severe due to the extreme force involved. In this case, a kick from a horse resulted in a complex larynx fracture, which is a serious injury that requires immediate medical attention.
Recommended Treatment Approach
- After discussing the heterogeneity in the literature regarding the appropriate airway management strategy, the researchers recommend tracheotomy instead of intubation. This is mainly because, in such severe cases, intubation would most likely result in incorrect placement of the tube or complete displacement of larynx and trachea.
- In addition to securing a vital airway through tracheotomy, the researchers suggest a timely reconstruction of the airways to ensure the patient’s well-being. This could be achieved by using a temporary tracheal stent if needed.
- According to the authors, the reconstruction procedure should ideally be performed within the first six hours following the accident. The timeliness of the procedure is critical to its effectiveness and to avoid further complications.
Role of the Emergency Physician
- The paper also sheds light on the significant role and responsibility of the emergency physician who provides initial treatment in such cases. The right course of action taken at this stage can drastically affect the patient’s recovery and long-term health.
Cite This Article
APA
Kilgué A, Teudt IU, Grundmann T, Püschel K.
(2014).
[Complex fracture of the larynx caused by a horse kick].
HNO, 62(12), 886-889.
https://doi.org/10.1007/s00106-014-2913-6 Publication
Researcher Affiliations
- Abteilung für Hals-, Nasen-, Ohrenheilkunde, Asklepios Klinik Altona, Paul-Ehrlich-Str. 1, 22763, Hamburg, Deutschland, a.kilgue@asklepios.com.
MeSH Terms
- Adult
- Airway Management / methods
- Animals
- Emergency Medical Services / methods
- Fractures, Cartilage / diagnosis
- Fractures, Cartilage / surgery
- Hoof and Claw
- Horses
- Humans
- Laryngeal Cartilages / diagnostic imaging
- Laryngeal Cartilages / injuries
- Laryngeal Cartilages / surgery
- Male
- Neck Injuries / diagnosis
- Neck Injuries / surgery
- Radiography
- Tracheotomy / methods
- Wounds, Nonpenetrating / diagnosis
- Wounds, Nonpenetrating / surgery
References
This article includes 12 references
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Citations
This article has been cited 1 times.- Radeloff K, Schraven SP, Radeloff D, Kraus F. [Functional rehabilitation of severe laryngopharyngeal injuries after near-lethal suicide attempt by hanging]. HNO 2019 Feb;67(2):110-117.
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