Steel Rod Impalement Injuries Involving the Spine: Case Reports and Literature Review
| Autor: | Kasım Turgut, Suleyman Kilinc, Seyho Cem Yucetas, Sadi Balli, Leyla Topcu Sarica, Necati Ucler, Can Sarica |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Perforation (oil well) Poison control Wounds Penetrating Perineum Lacerations 03 medical and health sciences 0302 clinical medicine Risk Factors Laparotomy Colostomy medicine Paralysis Humans Spinal canal 030212 general & internal medicine Spinal cord injury Spinal Cord Injuries Lumbar Vertebrae business.industry Laminectomy medicine.disease Magnetic Resonance Imaging Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Spinal Injuries Steel Emergency Medicine Accidental Falls medicine.symptom business Colonography Computed Tomographic 030217 neurology & neurosurgery |
| Zdroj: | Turkish Journal of Trauma and Emergency Surgery. |
| ISSN: | 1306-696X |
| Popis: | Steel rod impalements, mostly experienced by construction workers due to falls from heights, are known entities, but only some individuals unfortunately suffer spinal cord injury. The management of the spine involved injuries is challenging due to the lack of guidelines, various clinical presentations resulting from different trajectories, and high risk of infection. We report a case of steel rod impalement involving the spinal canal and review the literature to enhance the management strategies and to identify the risk factors for possible complications, particularly infection. A 37-year-old male construction worker presented to our emergency department due to falling onto a concrete reinforcing steel rod that penetrated through his perineum to the L4 vertebra. Examination revealed paralysis and sensory loss of the left foot. The rod was removed in the operating room (closed removal) under general anesthesia, followed by laparotomy. Rectal laceration was primarily repaired, and colostomy was performed. In a separate session, laminectomy was performed. At 3 months post-discharge, the patient was ambulatory with armrest based on the same motor examination performed on presentation This case is a good example of careful preoperative planning, multidisciplinary involvement, and appropriately sequenced interventions resulting in an acceptable outcome for an injury with high morbidity and mortality and demonstrates the feasibility and potential benefits of closed removal of the rod in an operating room just before laparotomy. The presence of an intestinal perforation increases the infection risk, but infections can still be prevented in this setting. Shorter time intervals between the incidence and surgery may reduce the infection rate. |
| Databáze: | OpenAIRE |
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