Craniofacial impalement injury: a rake in the face

Impalement injuries describe unusual objects and circumstances in which a body part is either partially embedded (one end sticking out) or transected (through-and-through) by a foreign material. In either case, the object remains as part of the wound and is highly conspicuous. These injuries are much more common on the trunk and extremities because of their larger surface areas and the relative ease in which the object may penetrate them without lethal consequences. In the face, however, such injuries are more rare because of protective reflexes that either move the face away from the coming object or permit it only to be deflected away without being embedded. In addition, the face presents a much smaller target than the rest of the body and, therefore, is more infrequently impaled. This paper presents a case that illustrates many of the classic features of the craniofacial impalement-type injury.