Banshelkikar Santosh Nagnath, Sheth Binoti A, Dhake Rakesh P, Goregaonkar Arvind B
Department of Orthopedics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.
J Orthop Case Rep. 2018 Jan-Feb;8(1):71-74. doi: 10.13107/jocr.2250-0685.1006.
Impalement injuries are one of the rare presentations in the emergency department and present complex surgical challenges in management. Prompt transfer to tertiary centre, pre-operative planning, and multi specialty involvement is crucial in the management of such cases.
We report a case of 18-year-old male who sustained impalement injury to thigh with an iron rod after falling from height. After quick assessment ofv ital parameters and ruling out major organ injury, wound extent was examined. In collaboration with vascular and plastic surgeons, the rod was successfully removed under direct vision. The patient recuperated without sequelae.
One should not get distracted by the appearance of the impalement injuries. After initial resuscitation, full trauma evaluation should be carried out before attending to local injury. Minimal manipulation, extraction of impaled object in operation theater under direct vision, wound debridement, and administration of antibiotics to prevent wound infection are pearls of the management of impalement injury.
穿刺伤是急诊科罕见的病症之一，在处理上带来复杂的外科挑战。迅速转至三级医疗中心、术前规划以及多专科参与对此类病例的处理至关重要。
我们报告一例18岁男性病例，该患者从高处坠落时被铁棍穿刺大腿。在快速评估生命体征并排除主要器官损伤后，检查了伤口范围。与血管外科和整形外科医生协作，在直视下成功取出铁棍。患者康复且无后遗症。
不应被穿刺伤的外观分散注意力。在初步复苏后，处理局部损伤前应进行全面创伤评估。尽量减少操作、在手术室直视下取出穿刺物、伤口清创以及使用抗生素预防伤口感染是处理穿刺伤的要点。
