A Case Report of Penetrating Extremity Trauma: A Near Miss Encounter

In penetrating injuries, neurovascular structures are the main concern as they can be damaged either at the point of injury or are at risk of iatrogenic damage during exploration. Lapse in planning and a hasty attempt at retrieval in the emergency, often results in retention of a part of the foreign body. In this case report, we emphasize the need for exploration in the operating room to prevent potential complications from missed foreign body.

A 24-year-old motorcyclist involved in a road traffic collision was received at our trauma center, with a foreign object sticking out from his lower third right arm. On clinical exam, there were no distal neurovascular deficits. A radiograph was taken and the patient was shifted to the theater. On exploration, the foreign body was removed with gentle manipulation after careful debridement, along its path of insertion. Only localized muscle injury was noted. All the surrounding neurovascular structures were intact. At 3 weeks, wound had healed with no residual symptoms.

Penetrating trauma is notorious for neurovascular injuries and therefore a meticulous history taking, clinical exam, and planning is vital. Exploration in the operating room is a must for complete and safe retrieval of the foreign body.