Thoracic impalement injuries are very rare and the majority of patients do not survive to reach a medical care facility. In this case report, we describe the successful outcome of a case of double thoracic impalement by two steel tors, of which one steel tor had impaled two patients simultaneously. The case report highlights all aspects of managing such rare and complex cases right from prehospital care; extrication process which happened under controlled environment at the trauma centre itself, till the definitive management of the impaled thoracic objects. Thoracic impalement injuries are dramatic and appear very challenging. However presence of mind of the managing team, coordinated team effort and availability of adequate facilities can lead to a successful outcome.
Humans ; Thoracic Injuries ; Wounds, Penetrating

OBJECTIVE: To study the deduction of injury-causing instruments and its value as judicial evidence. METHODS: To collect 146 cases involved in injury-causing instruments deduction, which accepted by Judicial Appraisal Center of Wannan Medical College during the period from 1998 to 2007, then to deduce the instrument by analyzing the characters of injuries in body surface. The accuracy of those deductions was evaluated by comparing the deduced instruments with the actual instruments. RESULTS: The deduction from sharp injuries was more accurate than that from blunt injuries. CONCLUSION Sometimes the result of deduction about injury-causing instruments are uncertain, it may be accepted as judicial evidence when supported by other evidences.
Female ; Forensic Pathology/methods* ; Humans ; Male ; Wounds and Injuries/pathology* ; Wounds, Nonpenetrating/pathology* ; Wounds, Penetrating/pathology*

The author experienced 96 cases of eyeball perforation from January 1980 to May 1982. Of those evaluated 24 cases of severe penetrating injuries involving vitreous gel were treated with pars plana vitrectomy. The conclusions were as follows: 1. Visual improvement was achieved in 45.B%, of the 24 patients with ocular penetrating injury treated by pars plana vitrectomy. 2. The prognosis was poorer in cases with scleral or corneoscleral injury than corneal penetrating injury. 3. The final visual prognosis was poorer in the 8 cases with large scleral laceration (more than 8mm) than in the other 16 cases. The visual acuity was limited to hand motion or less in 12 cases. 4. Those patients who were operated on between 2 weeks and 6 weeks after the injury had a better prognosis than others.
Eye Injuries/*surgery ; Humans ; Prognosis ; *Vitrectomy ; Wounds, Penetrating/*surgery

According to the literature, only a small proportion of occurrences regarding penetrating trauma of the thoracic aorta can be treated successfully. Herein we reported our experience of a recent rescue of such a patient in a countryside hospital lacking advanced instruments for cardiopulmonary bypass operations. A 20-year-old male was admitted for a penetrating injury with disrupted innominate vein and right common carotid artery together with a 1.5-cm laceration on the aortic arch between the innominate artery and the left common carotid artery. The patient was successfully saved without the implementation of cardiopulmonary bypass. Presentation and management in this case were discussed.
Adult ; Aorta, Thoracic ; injuries ; surgery ; Humans ; Male ; Wounds, Penetrating ; surgery

Penetrating injury to the rectum, vertebral body and spinal cord by a steel rod is a rare condition. Treatment of this kind of injury is very challenging. Rectal injury requires repair and fecal diversion, while debridement of the spine is difficult, especially when the injury site is very long. Here we report a case of penetrating injury of rectum and sacral vertebra by a steel rod after falling onto the ground from 1 m height. The abscess cavity was irrigated with 3% hydrogen peroxide and physio-logical saline repeatedly. The bony canal was carefully debrided, curetted and bony fragments were removed. Spinal irrigation and drainage lasted for 2 months and sensitive antibiotic (amikacin sulfate) was given 7 days after surgery, but abscess was still formed in the vertebral canal. At 6-month follow-up, the patient was paralyzed without any neurological improvement, and the pain in low back and lower limb still continued.
Abscess ; Drainage ; Humans ; Rectum ; Steel ; Wounds, Penetrating ; surgery

Humans ; Neck/surgery* ; Orbit/injuries* ; Thorax ; Wounds, Penetrating

Although the treatment strategy for colorectal trauma has advanced during the last part of the twentieth century and the result has improved, compared to other injuries, problems, such as high septic complication rates and mortality rates, still exist, so standard management for colorectal trauma is still a controversial issue. For that reason, we designed this article to address current recommendations for management of colorectal injuries based on a review of literature. According to the reviewed data, although sufficient evidence exists for primary repair being the treatment of choice in most cases of nondestructive colon injuries, many surgeons are still concerned about anastomotic leakage or failure, and prefer to perform a diverting colostomy. Recently, some reports have shown that primary repair or resection and anastomosis, is better than a diverting colostomy even in cases of destructive colon injuries, but it has not fully established as the standard treatment. The same guideline as that for colonic injury is applied in cases of intraperitoneal rectal injuries, and, diversion, primary repair, and presacral drainage are regarded as the standards for the management of extraperitoneal rectal injuries. However, some reports state that primary repair without a diverting colostomy has benefit in the treatment of extraperitoneal rectal injury, and presacral drainage is still controversial. In conclusion, ideally an individual management strategy would be developed for each patient suffering from colorectal injury. To do this, an evidence-based treatment plan should be carefully developed.
Abdominal Injuries ; Anastomotic Leak ; Colon ; Colorectal Surgery ; Colostomy ; Drainage ; Humans ; Stress, Psychological ; Wounds, Nonpenetrating ; Wounds, Penetrating

PURPOSE: This study was performed to evaluate the effect of amniotic membrane graft on corneal opacity after traumatic penetrating injury. METHODS: Corneal penetrating wound was made, 6mm in length. A total of 60 rabbit eyes were divided into three groups: (1) applied with amniotic membrane (n=20); (2) applied with contact lens (n=20); (3) control (n=20). Corneal opacity was analyzed with photoslit microscopy finding, histopathological finding, and expression of alpha-smooth muscle actin. RESULTS: Grade of corneal opacity was lower in amniotic membrane applied group (p<0.05). Infiltration of the inflammatory cells and expression of alpha-smooth muscle actin were also lower in amniotic membrane applied group. Histological structures of stromal cells were more regular in amniotic membrane applied group. CONCLUSIONS: Amniotic membrane graft can be an effective therapeutic method for prevention of corneal opacity after trauma by inhibiting infiltration of the inflammatory cells, proliferation of stromal cell and wound contracture by fibroblasts.
Actins ; Amnion* ; Contracture ; Corneal Opacity* ; Fibroblasts ; Microscopy ; Stromal Cells ; Transplants* ; Wounds and Injuries ; Wounds, Penetrating

OBJECTIVES: To study the morphological characteristics of the injury caused by ox horn on human body and its injury mechanism, and to discuss the rules and characteristics of injury by ox horn and provide forensic evidences for identification of such cases. METHODS: The comparative analysis of position and morphological characteristics were performed by summarizing the data of 100 victims gored by ox accepted by Heilongjiang agricultural areas public security bureau during 2004-2014. RESULTS: The specific injuries only could be found at the contact positions such as thorax and abdomen, lower back and limbs of the victims gored by ox horn. Most of the skin wounds had the characteristics of sharp injuries, the bar-type injury by club which called "rail way bruise" was an obvious characteristic appeared on the soft tissue. CONCLUSIONS Ox horn can cause non-specific injuries on thorax and abdomen, lower back and limbs of human body, which are similar with the characteristics of sharp injury and injury by club. Careful analyzation and identification should be performed on such injury in daily work.
Abdominal Injuries/etiology* ; Animals ; Cattle ; Female ; Humans ; Lower Extremity ; Thorax ; Wounds and Injuries/etiology* ; Wounds, Penetrating

In blunt abdominal trauma, the abdomen may be compressed and crushed without disruption of the skin, without external bruising, and yet extensive and fatal internal injuries may be present. The penetrating wounds are especially dangerous because of the possibility of grave injury to internal organs or major blood vessels. The majority are homicidal injuries: suicide by stabbing, or accidental stabbing, is infrequent. The abdominal injuries usually coexist with other-site injuries, especially with chest injuries. The homicide and the suicide often aim at the heart, in consequence wound the left side of the chest or upper abdomen. This review is discussed on the mechanism of the blunt and penetrating abdominal injury, types of injury, and significance of medicolegal aspects of the abdominal trauma.
Abdomen* ; Abdominal Injuries ; Blood Vessels ; Heart ; Homicide ; Skin ; Suicide ; Thoracic Injuries ; Thorax ; Wounds and Injuries ; Wounds, Nonpenetrating* ; Wounds, Penetrating