A Case of Dual Thoracoabdominal Impalement in Vehicular Trauma

Impalement injuries are relatively uncommon during vehicular trauma. We present a dual case report of patients sustaining simultaneous impalement injuries during a high-speed motor vehicle collision in a rural (austere) environment. After Institutional Review Board approval, we performed a review of...

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Bibliographic Details
Published in:The American surgeon 2008-08, Vol.74 (8), p.757-760
Main Authors: WINFIELD, Robert D, PARR, Alexander G, ANG, Darwin N, MARTIN, Tomas D, CHEN, Mike K, SEAGLE, M. Brent, HOCHWALD, Steven N, REED, Alan I, LOTTENBERG, Lawrence
Format: Article
Language:English
Subjects:
Accidents, Traffic
Adolescent
Biological and medical sciences
Diaphragm - injuries
General aspects
Heart surgery
Hospitals
Humans
Intensive care
Liver - injuries
Lung Injury
Male
Medical sciences
Neck Injuries - surgery
Passengers
Patients
Personal health
Plastic surgery
Skin & tissue grafts
Spleen - injuries
Surgical Flaps
Thoracic Injuries - surgery
Thoracotomy
Trauma
Wounds, Penetrating - surgery
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Summary:Impalement injuries are relatively uncommon during vehicular trauma. We present a dual case report of patients sustaining simultaneous impalement injuries during a high-speed motor vehicle collision in a rural (austere) environment. After Institutional Review Board approval, we performed a review of the patients' medical records. Two young men were traveling in an automobile at high speed when the driver lost control of the vehicle, causing it to strike a wooden fence. Portions of the fence were dislodged, penetrated the windshield, and impaled both the driver and passenger. Both patients were extricated rapidly and transported to our trauma center. Multidisciplinary teams consisting of trauma, thoracic, plastic, and hepatobiliary surgeons addressed the injuries of both patients. Both survived their injuries and have since returned to their homes. This case of dual impalements highlights three key points: first, the principles of management of thoracoabdominal impalement injuries; second, the importance of rapid action of first responders in complex traumas; and finally, the value of using a multidisciplinary surgical team in complicated trauma cases.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313480807400818