Pediatric Forearm Impalement Injury: A Case Report with Review of Literature.

Abstract

Impalement injuries are relatively rare injuries but they can present with significant surgical challenges depending on the site of injury. They can occur through a variety of mechanisms such as fall on a sharp object, assault with a sharp object, high-velocity road traffic accidents, and shrapnel injuries during a blast. Adequate pre-operative planning and surgical execution is of utmost importance for optimal outcome. We report a case of a 7-year-old child who presented with an impalement injury with a metal rod of a fence, following a fall on the fence while playing. The rod was removed under vision after ruling out any vascular injury. The child recovered without any residual deficits or sequelae. Proper history and mechanism of injury should be verified at the outset. Complete evaluation should be done to make sure it is a local injury; vascular and neurological status needs to be confirmed and documented before any procedure. Removal under vision in the operating theater under the cover of adequate antibiotics and debridement and wound lavage reduces rates of infection and post-operative morbidity.