Background: Cervical trauma is a common cause of disability following spinal cord injury especially in athletic populations. The biomechanics in the atlantoaxial joint carry more than 50% of the rotational movement which can be affected in transverse ligament tear associated with odontoid fracture type II. Odontoid fracture type II is considered an unstable fracture with a high rate of nonunion in conservative treatment. Limitation of the odontoid screws in some cases gives the chance of posterior cervical fixation to have the superior role. Use of polyaxial screws in Harms technique gives the best results in maintaining majority of the biomechanics.Purpose: Our aim in this study is to evaluate Harms technique in patients regarding pain improvement and restoration of the motor power and to report the complications.Study design: This is a retrospective case series study. We used the Frankel grading system to evaluate the postoperative neurological state. , 12 patients were introduced to the neurosurgical department at the Sohag University Hospital with post-traumatic type II odontoid fracture with failure of conservative treatment and not suitable for anterior odontoid screws. All patients underwent full laboratory, medical, and neurological evaluation and imaging study on the cervical spine. All patients underwent posterior cervical fixation C1-C2 by polyaxial screw Harms technique. Results: Male ratio was predominant in our study: 75% with a mean age 34.4 years. Neck pain with limitation of the neck movement was the complaint for the all cases. Three cases came with neurological affection. Postoperative superficial infection reported in one patient; no vertebral artery or neural injuries were noticed in our study. Conclusion: Harms technique C1-C2 fixation is a valuable choice in patients with type II odontoid fracture with failure of conservative treatment or not suitable for odontoid screw. Harms technique gives us the highest preservation of the biomechanics among the other posterior approaches. Trial registration: NCT03768843.

Background: Non-missile penetrating brain injuries are rarely seen in the surgical practice and few international literatures' reported case reports or small case series, and it comprises a small percentage of head trauma cases. We reported a group of 18 cases of penetrating injuries with different tools and various mechanisms. We reported their epidemiological criteria, mechanism of trauma, complications, and their prognosis. Aim: The purpose of this study is to report different patients' criteria and the method of trauma and the prognosis.Patients and methods: A retrospective study was done in Trauma unit, Sohag University, between November 2012 and October 2014. Eighteen patients were reported with different mechanisms of trauma. All patients were clinically tested and subjected to CT brain. Cautious removal of the penetrating object with debridement of surrounding tissues was done. Patients were transferred to ICU for 48-72 h. Results: Patients were subjected to operative intervention, and they were followed up for 3 years. Males were the predominant gender, 13 cases (72.2%), and the young age was higher than the elderly. The Glasgow outcome score was 15 in 13 patients and was 4 in five patients. Transient epileptic fits occurred in six patients and controlled on antiepileptic drugs. Five patients had a neurological deficit in the form of hemiparesis or monoparesis.Conclusion: Penetrating head injuries, although rare, are dangerous and should be cautiously managed and monitored in the ICU. The prognosis depends mainly on initial GCS and ventricular involvement, but in general, the prognosis is favorable.

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