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Results for “Neck Injuries”

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At least 199 records · Page 11Linked to original sources
PubMed1994

Selective surgical management in penetrating neck injuries.

OBJECTIVE: To evaluate selective operative management in penetrating neck trauma. DESIGN: A chart review. SETTING: A university-affiliated hospital in Johannesburg, South Africa. PATIENTS: All adults admitted to the hospital between January 1988 and June 1993 with a penetrating neck wound. Excluded were patients in whom there was no suspicion of an occult injury that might need further investigation. There were 755 patients in the study. INTERVENTIONS: Immediate surgical exploration (group A, 613 patients) and observation with constant monitoring (group B, 142 patients). MAIN OUTCOME MEASURES: Unnecessary explorations in group A and missed significant injuries in group B. RESULTS: In group A there was a 3% incidence of unnecessary explorations, and 4.2% of the patients died. In group B there was a 9.1% incidence of missed injuries, and 2.8% of the patients died as a result of the delayed diagnosis. Overall the death rate was 4%. CONCLUSION: Selective operative intervention for penetrating neck trauma results in fewer negative explorations and a death rate comparable to those of series that support mandatory neck exploration.

Adolescent↗
PubMed1989

Penetrating neck injuries: recommendations for selective management.

There were 225 patients with penetrating neck wounds admitted over a 4-year period. Mechanism of injury included stab wounds in 59%, gunshot wounds in 32%, and shotgun wounds in 9%. Location of injury was Zone 1, 16%, Zone 2, 42%, Zone 3, 18%, posterior triangle, 12%, and multiple, 12%. The patients were divided into five groups based upon clinical presentation, location of injury and method of management: Group 1 (n = 31) had serious blood loss or respiratory distress and were immediately explored; Group 2 (n = 76) had anterior wounds and equivocal physical findings either without (n = 60) or with negative (n = 16) contrast studies and these had "mandatory explorations"; Group 3 (n = 17) and Group 4 (n = 80) presented the same as Group 2 but Group 3 patients had positive contrast studies and were explored, while contrast studies were negative in Group 4 patients who were observed; Group 5 (n = 21) had posterior injuries and/or presented late with minimal physical findings and they were observed. Positive exploration occurred in 90% of Group 1, 28% of Group 2, and 82% of Group 3. There were no missed injuries in Groups 4 or 5. Two missed esophageal injuries occurred in Group 2, and a missed carotid injury occurred in Group 3. The following guidelines for management have resulted. 1) Unstable patients require immediate exploration. 2) Stable patients with equivocal physical findings can be managed according to results of esophageal examination and angiography. 3) Patients with low probability of injury due to location and clinical presentation can be observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Neck injuries].

An analysis of treatment of 85 patients with wounded neck during 20 years has been made. Twenty two patients (25.9%) had no clinical symptoms of injuries of the vitally important organs when admitted to the hospital and stayed under observation. Negative data were found during examination of the wound in 39 of 63 patients (61.9%) operated upon. The authors believe that in most cases no traditional revision of the wound should be performed. Selective tactics and individual approach to treatment of such injuries is necessary.

Blood Vessels↗
PubMed1977

Carpal tunnel syndrome or trigger finger associated with neck injury in automobile accidents.

Among 450 patients examined for neck pain following automobile accidents, carpal tunnel syndrome (CTS) was diagnosed in four and trigger finger (TF) in three. All seven patients sustained cervical sprains and were drivers or passengers in automobiles which received impacts from the rear. All seven patients reported the onset of hand symptoms during or shortly after the accident. This unusual occurrence, not previously reported, appears to be related to the events which occurred at the time of the accident. The mechanism of injury for CTS is hypothesized to be median nerve compression by momentary acute hyperflexion or hyperextension of the wrist(s), while tightly grasping the steering wheel or bracing for impact. The cause of TF is suspected to be direct trauma to the flexor tendon and sheath by compression against bony prominences when the finger is hyperflexed or hyperextended. This can occur during the accident while forcefully grasping the steering wheel with acutely hyperflexed fingers.

Accidents, Traffic↗