The Second Look after Fights: Why Wounds Might Not Only Be Superficial

Area of Science:

• Trauma Surgery
• Orthopedic Surgery
• Emergency Medicine

Background:

• Intraosseous foreign bodies from stab wounds are uncommon.
• Initial assessment of stab wounds can sometimes miss deep tissue or bone penetration.

Purpose of the Study:

• To report a rare case of intraosseous foreign body penetration of the femur.
• To emphasize the importance of considering the injury mechanism in stab wound evaluation.

Main Methods:

• Case report of a 17-year-old patient with a knife injury to the knee.
• Initial wound exploration without radiographic evaluation.
• Subsequent detailed history and radiographic examination revealing intraosseous penetration.

Main Results:

• A broken knifepoint was found penetrated into the intraosseous tissue of the femur.
• Initial assessment in knee extension failed to detect the deep foreign body.
• Radiography confirmed the intraosseous location of the foreign body.

Conclusions:

• Intraosseous foreign bodies from knife attacks are rare but serious.
• Local wound exploration for stab wounds must account for the mechanism of injury and joint position.
• Radiographic evaluation should be strongly considered in suspected deep stab wound injuries.