An unusual mechanism of hook impalement injury - A case report

Abstract

A six-year-old boy was playing at his home, trying to climb up on a metallic gate which was attached with a hooked chain, and suddenly the child slipped down. The hook of the chain, including its 'U' shape segment got embedded into the posteromedial aspect of his thigh, through a small entry wound. An anteromedial aspect of the thigh carries a neuro-vascular bundle of the lower limb. To remove the hooked part from muscles near to femoral vessels without damaging them requires surgical skill and consideration for vascular emergencies. At the same time, the procedure is an important step. After resuscitation, the patient is taken into the emergency operation theatre, and the hook was safely removed under vision. In the postoperative period, the child recovered well, and the wound was healthy at the time of discharge.

Keywords: Hook injury; Impalement; Paediatric trauma; Penetrating injury; Unusual mechanism.

Fig. 1

Hook is embedded into right medial aspect of thigh.

Fig. 2

Position of hook in the thigh-intraoperative.

Fig. 3

Skiagram showing hook in the thigh.

Fig. 4

Hook after removal.

Fig. 5

Whole chain with attached hook.