Mann Adam J, Lottenberg Lawrence, Azar Faris, Hus Nir
General Surgery, Florida Atlantic University, Boca Raton, USA.
Surgery, Florida Atlantic University/St. Mary's Medical Center, West Palm Beach, USA.
Cureus. 2023 Jan 8;15(1):e33517. doi: 10.7759/cureus.33517. eCollection 2023 Jan.
Impalement injuries secondary to motor vehicle collisions are rare. Reviewing the systematic approach to treating these injuries can benefit the surgical community. This case report discusses the presentation and management of a 32-year-old male who was involved in a high-speed, roll-over motor vehicle collision. The car struck a chain-link fence, and the unrestrained passenger sustained a fence post impalement injury to his right thorax. He was alert and oriented when emergency services arrived. He was extricated rapidly and transported to our level-one trauma center, where he received definitive operative management. The patient survived the injury and was discharged home. This case highlights key points in the systematic approach to impalement injuries, including minimal handling of the impaled object, expedient transfer to the local trauma center, emergent operative intervention, vascular control prior to removal of the foreign object, and aggressive irrigation and debridement of the wound.
机动车碰撞导致的穿刺伤很罕见。回顾治疗这些损伤的系统方法对外科界有益。本病例报告讨论了一名32岁男性的临床表现及治疗，该患者遭遇了一起高速翻车机动车碰撞事故。汽车撞上了铁丝网围栏，未系安全带的乘客右胸被围栏柱穿刺伤。紧急服务人员到达时，他神志清醒、定向力正常。他很快被解救出来并被送往我们的一级创伤中心，在那里接受了确定性手术治疗。患者伤后存活并出院。本病例突出了穿刺伤系统治疗方法中的关键点，包括尽量减少对穿刺物的处理、迅速转运至当地创伤中心、紧急手术干预、在取出异物前控制血管以及积极冲洗和清创伤口。
