The incidence of penetrating and lacerated neck injuries has been rising in recent decades largely because of urban violence. Injury to the neck frequently results in multiple regional injuries and in addition poses serious threat to vital structures in the neck.From 1999 to 2005, forty-two cases of penetrating neck injuries which were treated in our hospital were included in this study. Thirty one (73.8%) injuries were due to homicide, six cases (14.2%) were due to suicide attempt and five (11.9%) were accidental injuries. Surgical management included tracheostomy neck exploration and wound repair. All the patients were followed up for a minimum period of six months. Six patients (14.2%) had unilateral vocal cord paralysis. Two patients (4.7%) developed tracheal stenosis.A proper evaluation, rapid air way intervention and proper surgical repair are essential for a successful outcome.
Ultrasound guidance for steroid injection in de Quervain disease is useful in identifying the presence of subcompartments and effectively injecting the drug into tendon sheath. We prospectively studied 50 patients with features of de Quervain disease to determine the effectiveness of ultrasound in positioning of needle for steroid injection and effectiveness of single versus multiple injections in the presence of subcompartments. Scalp vein set was inserted into the tendon sheath under ultrasound guidance and sterile conditions. Mixture containing 1 mL of methylprednisolone 40?mg with 1 mL of 2% lignocaine was injected and the patient followed for 6 months. In patients having subcompartments, improvement was better when two separate injections into each subcompartment were given compared with single. Ultrasound guidance is helpful in identifying the existence of subcompartment and injecting the subcompartments separately. Scalp vein set may be very effective in ultrasound-guided injection. This is a level III study.
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