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Penetrating pencil injury: an unusual case of child abuse
Insights
A young child sustained a deep penetrating hand injury from a pencil. This unusual case highlights the importance of considering nonaccidental injury in pediatric pencil-related trauma.
Area of Science:
- Pediatric Trauma
- Child Abuse Forensics
Background:
- Penetrating injuries in children are often accidental.
- Deep-seated pencil injuries are rare and typically involve the oropharynx or orbit.
Observation:
- A 4-year-old boy presented with a penetrating wound to the right hand after a reported fall.
- A 1.3 cm graphite fragment was surgically removed from the palm.
- The injury was subsequently revealed to be intentional, inflicted by the mother.
Findings:
- The case involved a deep penetrating pencil injury to the hand in a young child.
- The initial report of accidental injury was contradicted by the true cause: physical abuse.
Implications:
- Healthcare providers should maintain a high index of suspicion for nonaccidental trauma in cases of deep penetrating pencil injuries.
- Increased public awareness is needed regarding the potential for child abuse presenting as seemingly accidental injuries.
Objective:
We report an unusual case of penetrating pencil injury in a young child that turned out to be a case of physical abuse.
Method:
This is a case report with review of the literature.
Results:
A 4-year-old boy was brought by his mother to the accident and emergency department for a penetrating wound of the right hand. He was said to have injured himself during a fall at home while holding a sharpened lead pencil. The pencil broke after penetrating the hypothenar eminence, leaving the graphite tip embedded in the palm. On surgical exploration, a piece of graphite measuring 1.3 cm was removed. The injury was actually inflicted by his mother because he failed to complete his homework properly. Deep penetrating injuries associated with the lead pencil are uncommon events in the medical literature. They are often reported as accidental and usually involve the oropharynx and the orbit.
Conclusion:
Deep penetrating injury with a pencil is unusual in childhood and the public should be made aware of the possibility of nonaccidental injury.