Impalement injuries of the oral cavity in children: a case report and survey of the literature

Abstract

A survey of the literature confirms that most injuries of this kind can be treated conservatively, and in many cases, without surgical intervention. However, careful assessment by an experienced clinician is necessary to rule out other complications. The present paper discusses the prevalence, management and complications associated with impalement injuries of the oral cavity in children.

Oral and oropharyngeal impalement injury in pediatric patients—Focus on rural environment

“…[1][2][3][4][5][6][7][8][9][10] From the epidemiological perspective, the injury is predominantly found in pediatric patients who are less than 10 years and affects boys more often than girls. 1,8 This article concurs with these findings.…”

“…In some publications, the wound is sutured, irrespective of the nature of the traumatic object, and sometimes irrespective of the time that has elapsed between the occurrence of the incident and the time of treatment. [3][4][5]7 This article highlights the heavily soiled nature of the traumatic objects (rusted steel wire, wooden stick) encountered in the rural environment. Therefore, the present authors suggest that it is good practice to generously irrigate the penetrating wound with normal saline solution and then to leave it open (unsutured).…”

“…[1][2][3][4][5][6][7][8][9][10] The clinical presentation in most reported cases usually consisted of only a few symptoms. [3][4][5][6][7] The entrance wound was small with no active bleeding in the majority of cases. This clinical picture of "mild trauma" on an otherwise stable patient might in some cases mislead parents and health care providers towards initial under-diagnosis and under-estimation of the possibility of serious, delayed complications.…”

“…However, the majority of intraoral impalement injuries were successfully treated with minimal surgery and healed without major sequelae. 1,[3][4][5][6][7][8][9][10] A variety of injuring objects have been described in the literature. 1,4,8,13 In general, many other objects, sharp or blunt, may create trauma to the oral cavity and its surrounding soft-tissue structures (Fig.…”

Severe Injury Caused by a Traumatic Toothbrush Impalement: A Case Report

“…Así, las lesiones penetrantes son más comunes durante la primera infancia, particulmente en varones, menores de cuatro años de edad (11)(12)(13), en comparación con la población adulta, debido que a las habilidades motoras de los niños están menos desarrolladas, por lo que tienden a cepillarse vigorosamente o a realizar otras actividades, manteniendo el cepillo en su boca (14,15). La gravedad de daños a los tejidos blandos orofaríngeos reportada oscila entre las abrasiones menores con bordes romos, hasta laceraciones profundas y herniación de la placa adiposa (16)(17)(18), ya sea por la incrustación del cepillo completo o de alguna de sus partes (19).…”