Undiagnosed impacted knife blade from a penetrative orbital injury: A case report. (2018)

• Record Type: Journal Article
• Authors: El Sayed, Mohamed; Hassan Saad, Reem; Fereir, Ahmed
• Is Part Of: International journal of surgery case reports. Volume 53(2018)
• Page Start: 254
• Page End: 258
• Publication Date: 2018
• Subjects: Facial trauma -- Stab wounds -- Foreign body -- Maxillofacial -- Orbital injury -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2018.10.064
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: The mode of entry of the foreign body was unique as well as the force required to impale and break a knife blade in bone. The authors present a minimally invasive technique for dealing with this type of injury and highlight its challenges. This case report emphasis the need for baseline radiology in cases of traumatology especially those with vague history. The patient was examined by multiple physicians who did not detect the foreign body which could raise medico-legal issues. Abstract: Introduction: Impacted foreign bodies in the complex maxillofacial region is uncommon and their safe removal is a challenge. Case presentation: The authors report an unusual case of a 41 year old male patient who suffered from violence-related orbital trauma with a knife. The presence of this foreign body was not diagnosed for a period of 20 months. After proper clinical and radiologic examination it was localized and extracted in the theater in a safe controlled manner. Although the tip of the blade was left in situ, the patient had a rapid uneventful recovery and follow up. Discussion: The path of penetration of the foreign body in presented case didn't follow the predicted patterns of orbital injury described in literature. A dilemma exists as to how aggressive such injuries should be managed. Thus the surgical approach implemented for retrieving the current foreign body was highlighted. Conclusion: Radiographs are a crucial element for early diagnosis and proper management of foreign body injuries. Rapid postoperative recovery can be achieved with simple safe surgical retrieval maneuvers.