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Open Access Case report

An unusual case of orbito-frontal rod fence stab injury with a good outcome

Massimo Miscusi1, Paolo Arangio1, Luca De Martino2, Fabio De-Giorgio3*, Piero Cascone4 and Antonino Raco2

Author Affiliations

1 Department of Medical and Surgical Sciences and Biotechnologies, Rome, Italy

2 NESMOS Department, Rome, Italy

3 Institute of Legal Medicine, Catholic University of the Sacred Heart, 00168 Rome, Italy

4 Department of Odontostomatologic and Maxillo-facial Sciences, Sapienza University of Rome, Rome, Italy

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BMC Surgery 2013, 13:31  doi:10.1186/1471-2482-13-31

Published: 13 August 2013

Abstract

Background

High-energy non-missile penetrating injuries (stab injuries) account for a small percentage of penetrating head injuries and they present a series of special features.

Case presentation

A 35-year-old man suffered orbito-frontal? and trans-cranial injuries after falling five meters from a terrace onto a rod iron fence. The removal of the metal rod was performed outside the operating room. The orbital roof was exposed and repaired through a bifrontal craniotomy and the frontal sinuses were cranialised. The orbital floor and zygoma were plated with micro-screws.

Conclusion

The patient recovered without significant complications, apart from a slight paresis of the right superior rectus; the ocular globe remained intact.

The positive outcome obtained in this very challenging case is attributable to the competency of the Neurotrauma Unit and to the use of a synergistic approach which involved the contribution of neurosurgeons, maxillo-facial surgeons, radiologists and anaesthesiologists.

Keywords:
Rod; Penetrating head injury; Orbital trauma; Cranial reconstruction