Paucis Verbis: Distracting injuries in c-spine injuries

"Distracting injury" is a frequent cited reason for imaging the cervical spine in blunt trauma patients, per the NEXUS study . In the Journal of Trauma in 2005 and 2011, studies aimed to narrow the definition of "distracting injury". Although both are studies at different sites, both conclude the same

• Chest injuries may be considered "distracting injuries" because of their proximity to the cervical spine.  

So let's say you are caring for a non-intoxicated motor vehicle crash patient with an isolated tibia fracture (i.e. a "long bone fracture"), no chest injuries, and no neck pain/tenderness. Per the NEXUS criteria, you might consider this patient to have a "distracting injury" because of the long bone fracture. Instead, the literature now supports your clinically clearing the cervical spine without imaging.