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Severe facial injury after falling onto a wooden fence!

⚠️A 15-year-old boy reported to the emergency department after falling from a tree onto a wooden fence!


Patient was conscious and well-oriented in time and place. He reported after 30 minutes of the injury. He was given 1ml 0.5 mg tetanus vaccine. On presentation the patient was having pain over the injury site with a foreign body in situ, his vitals were stable (pulse rate: 80/min, blood pressure: 120/80 mmHg). Thorough examination of the site of injury and facial nerve examination was done where there was no evidence of facial nerve injury. Computed tomography (CT) scan of the neck and face was done to rule out injury to vascular structures and see the extent of the injury. CT scan revealed that the foreign body was superficial to the investing layer of deep cervical fascia and all the major neurovascular structures were intact. After identification of the retained foreign object, surgical exploration and removal of the foreign body was made under general anaesthesia.



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