Sasaoka Y, Kamada K, Matumoto M, Ueda Y, Iwasaka T, Hukushima T, Nishimura A, Mishima H, Inoue M
Department of Neurosurgery, Nara Prefectural Critical Care Center.
No Shinkei Geka. 1995 Dec;23(12):1099-104.
A very rare case of directly penetrating injury of the head, neck and chest caused by a nail-gun was reported. A 56-year-old male was admitted to our critical care center due to chest injury. On admission, he showed numbness of the hand & leg, left hemiparesis and hypalgesia. Physical examination disclosed three nails on the left anterior chest, but other wounds or nails were not found. Chest films showed three nails penetrating the lung without reaching the heart, but other nails were found by skull and neck films. One nail had penetrated the cervical canal at the C1 level through the posterolateral cervical region. Two other nails were demonstrated at the right temporal and the left frontal region, Computed tomography revealed no massive cerebral hemorrhage and cerebral angiography showed no extravasation and no passage through main vessels. Emergency surgery was performed uneventfully and the nails in the chest, neck and head were totally removed. He was discharged one month after surgery. Some injuries caused by a nail-gun have been reported in the world literature but in Japan this multiple injury case was the first reported. Since nail-gun injuries can cause multiple damage, systemic X-ray examination was very important.
报告了一例非常罕见的由射钉枪导致的头、颈和胸部直接穿透伤。一名56岁男性因胸部受伤被收治入我们的重症监护中心。入院时，他表现出手脚麻木、左侧偏瘫和痛觉减退。体格检查发现左前胸有三根钉子，但未发现其他伤口或钉子。胸部X光片显示三根钉子穿透肺部但未到达心脏，但通过头颅和颈部X光片发现了其他钉子。一根钉子通过颈后外侧区域在C1水平穿透了椎管。另外两根钉子分别位于右侧颞部和左侧额部，计算机断层扫描显示无大量脑出血，脑血管造影显示无血管外渗且未穿过主要血管。急诊手术顺利进行，胸部、颈部和头部的钉子被全部取出。术后一个月他出院了。世界文献中已有一些关于射钉枪致伤的报道，但在日本，这例多发伤病例是首次报道。由于射钉枪伤可导致多处损伤，全身X光检查非常重要。
