Cervical Impalement Injury

Abstract

Impacted injuries of the head and neck are uncommon. Associated injuries can be present and can be a serious problem. We present an unusual clinical case and discuss the management of this complex injury. Head and neck injuries deserve special attention because of their enormous functional and esthetic significance. Contusion, abrasion, retained foreign bodies, laceration, and avulsion are some of the most frequent injuries. Impalement injuries are not so common. These lesions combine aspects of blunt and penetrating trauma and usually result from penetration by a large, rigid, blunt-tipped object that traverses a certain body area in a through-and-through fashion and often remains in situ at the time of presentation. There have been many case reports describing these injuries in the trunk and extremities; however, cases of head and neck impalement are still lacking in number. A case of an unusual cervical impalement is presented, together with a discussion of the management of this complex injury.

Facial Trauma

“…Blunt and penetrating trauma to the neck account for approximately 7% of head and neck injuries in children (Ferreira et al 2004(Ferreira et al , 2015a. Penetrating injuries of the neck are a complex type of trauma which can be life-threatening and are usually managed by a number of specialists.…”

“…Impalement injuries combine aspects of blunt and penetrating trauma and usually result from penetration by a large, rigid, blunt-tipped object that traverses with great force a certain body area in a through-and-through fashion and often remains in situ at the time of presentation (Ferreira et al 2004). These uncommon injuries usually result from accidents like motor vehicle accidents or falls or from falling objects.…”

“…Associated vascular, neurological, and skeletal injuries can be present in neck injuries and can be a serious problem. Further investigations, such as radiography, computerized tomography, magnetic resonance imaging, and angiography, are useful in assessing injuries; however, the patient's clinical state determines the balance between preoperative investigations and delivery to the operating room (Gassner et al 2004;Haug and Foss 2000;Imahara et al 2008;Muniz 2008;Atabaki 2007;Ferreira et al 2004).…”

A rare case of a penetrating cranio-facial foreign body stuck in the skull base

“…Craniofacial traumas are one of the most common clinical events of the 21st century. The possibility of associated injuries of the head and neck may determine functional and cosmetic problems in these patients [ 1 ].…”

Response to Lieder and Wilson

“…Removal should therefore only be effected on an anaesthetised patient in an operating theatre with the necessary equipment and support to cope with the possible consequences of removal, the primary concern being the potential for significant haemorrhage. Ferreira et al 2 . present a case of cervical impalement injury that illustrates and discusses the relevant issues further.…”