Kerketta AH, Kumar R, Sahu S, Laik JK, Rajak MK. Wooden foreign body impalement through the right shoulder region – an unusual penetrating injury: A case report. World J Orthop 2022; 13(12): 1064-1068 [PMID: 36567864 DOI: 10.5312/wjo.v13.i12.1064]
Corresponding Author of This Article
Abhay Harsh Kerketta, MBBS, MS, Surgeon, Department of Joint Replacement and Orthopaedics, Tata Main Hospital, C Road West Northern Town, Bistupur, Singhbhum 831001, Jharkhand, India. abhayharsh78@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Abhay Harsh Kerketta, Ritesh Kumar, Jayanta Kumar Laik, Manoj Kumar Rajak, Department of Joint Replacement and Orthopaedics, Tata Main Hospital, Singhbhum 831001, Jharkhand, India
Seelora Sahu, Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
Author contributions: Kerketta AH and Kumar R contributed equally to this work; Kerketta AH and Sahu S designed the case study; Kumar R, Laik JK, and Rajak MK performed the research; Kerketta AH and Sahu S wrote the manuscript and analyzed the data; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: We have no financial relationships to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abhay Harsh Kerketta, MBBS, MS, Surgeon, Department of Joint Replacement and Orthopaedics, Tata Main Hospital, C Road West Northern Town, Bistupur, Singhbhum 831001, Jharkhand, India. abhayharsh78@gmail.com
Received: July 25, 2022 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
