Abstract CRICOID FRACTURE with complete avulsion of the trachea is usually fatal. In closed, nonpenetrating injuries, it is difficult to imagine large numbers of survivors. Observations regarding the problems associated with the management of such a case are herein presented. As the trachea is an elastic structure, it should not be subject to great stress from purely stretch injuries. Tracheal ruptures have been reported from a blow on the chest during a period of glottic closure, such ruptures being the result of marked increase in intratracheal pressure, probably occurring with the trachea under stretch due to extension of the head.1 Such a force may also produce recurrent laryngeal nerve injury. Cricoid fractures are usually incurred in a head extended position due to direct force of considerable magnitude. Tracheal retraction occurs with avulsion due to the elasticity of the intercartilaginous ligaments.2 Such an injury allows no time for extended diagnostic References 1. Beskin, C.A.: Rupture-Separation of the Cervical Trachea Following a Closed Chest Injury: Report of a Case Successfully Treated by Primary Anastomosis , J Thorac Surg 34:392, 1957. 2. Shaw, R.R.; Paulson, D.L.; and Kee, J.L.: Traumatic Tracheal Rupture , J Thorac Cardiovasc Surg 42:281, 1961. 3. Harrington, O.B.; Beall, A.C., Jr.; and De Bakey, M.D.: Traumatic Injuries of Cervical Trachea , Amer J Surg 91:581, 1956.Crossref 4. Shirley, A.L.; Beall, A.C., Jr.; and De Bakey, M.D.: Surgical Management of Penetrating Wounds of the Neck , Arch Surg 86:955, 1963.Crossref 5. Ogura, J.H., and Roper, C.L.: Surgical Correction of Traumatic Stenosis of Larynx and Pharynx , Laryngoscope 72:468, 1962.Crossref 6. Nach, R.L., and Rothman, M.: Injuries of the Larynx and Trachea , Surg Gynec Obstet 76:614, 1953. 7. Conley, J.J.: Reconstruction of the Subglottic Air Space , Ann Otol 62:477, 1953.
Archives of Otolaryngology – American Medical Association
Published: May 1, 1968
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