Published online Dec 18, 2022. doi: 10.5312/wjo.v13.i12.1064
Peer-review started: July 25, 2022
First decision: September 26, 2022
Revised: October 17, 2022
Accepted: November 4, 2022
Article in press: November 4, 2022
Published online: December 18, 2022
Processing time: 143 Days and 18.9 Hours
Impalement of the body is a rare injury and comes with varied presentation. There is no set classification or defined protocols for managing this injury. This case report aims to create awareness among trauma surgeons about unusual presentation and management of such case.
A 45-year-old man presented to the emergency department with a sharp penetrating wooden plank at right clavicular region between the neck and shoulder following a road traffic accident. The vehicle had crashed into a roadside wooden hut, thus causing an impalement injury. He was meticulously worked up and taken to emergency theatre. The wooden plank was removed and the wound healed uneventfully. Postoperatively, he had fairly good shoulder function and was able to return back to work successfully.
Each impalement injury brings in challenges in management as no two cases are the same. The varied presentation and risks involved should be known to medical professionals handling the emergency. Coordinated multidisciplinary team approach is needed for successful outcome.
Core Tip: Penetration of the body, cavity, or region by an elongated object which remains in situ is called impalement injury. It can result from both penetrating and blunt trauma, with the severity of injury being factored by mechanism and velocity of trauma. Associated crushing, penetration, tissue loss, wound contamination, major fractures, and massive blood loss bring great challenges to surgeons besides posing difficulty in administering anesthesia.