Penetrating Injury by an Iron Reinforcing Bar Associated with a Fall or Slip Injury

Kim, Yong Jeong; Lim, Dae Jin; Park, In Sik; Chi, Hoon Sang

Abstract

INTRODUCTION: There was increase in a fall injury at the field of construction work, nowadays. There was also increase in penetrating injury by an iron reinforcing bar associated with a fall or slip injury. But this is not widely discussed in the surgical literature. The purpose of this study was to define the characteristics of injury, diagnosis, treatment and prognosis of the penetrating injury by an iron reinforcing bar associated with a fall or slip injury.
METHODS
AND MATERIALS: We reviewed retrospectively medical records of 17 patients who admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating injury by an iron reinforcing bar associated with a fall or slip injury from Nov. 1987 to Dec. 1996.
RESULTS
The penetrating injuries by an iron reinforcing bar associated with a fall or slip injury were 5 cases of a slip injury and 12 cases of a fall injury. The insertion site of an iron reinforcing bar was perineum in all of a slip injury. In a fall injury, insertion site was flank and back in 5 cases, perineum 4 cases, chest 2 cases and abdomen 1 case. In a fall injury, 9 patients had two or more organ injuries. CT scan was taken in 3 cases, sigmoidoscopy 3 cases and fistulogram 1 case in a slip injury. CT scan was done in 5 cases, sigmoidoscopy 1 case, cystogram 2 cases and intravenous pyelogram 1 case in a fall injury. 2 cases was cured conservatively, and operation was done in 3 cases in a slip injury in contrast to 2 cases of conservative management and operation 10 cases in a fall injury. There was no negative celiotomy. Complication was only one wound infection in a slip injury. There were wound infection 6 cases, pulmonary complication 4 cases, sepsis 1 case, necrotizing fascitis 1 case, anal sphincter injury 1 case, intraabdominal abscess 1 case and neurogenic bladder 1 case in a fall injury. There was no mortality.
CONCLUSION
The penetrating injuries by an iron reinforcing bar associated with a fall or slip injury had characteristics of both penetrating and blunt injury. The chest and abdominal penetrating injuries lead to multiple organ injury. In perineal penetrating injury, we should evaluate the injury of urinary bladder, rectum and genital organ.