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J Thorac Cardiovasc Surg 2003;125:954-955
© 2003 The American Association for Thoracic Surgery

Brief Communications

Thoracic impalement after ultralight aircraft crash

From the Trauma Unit, Johannesburg Hospital, and the Department of Surgery, University of the Witwatersrand Medical School, Johannesburg, Republic of South Africa.

Received for publication Aug 8, 2002. Accepted for publication Aug 22, 2002. Address for reprints: Professor K. D. Boffard, Johannesburg Hospital Trauma Unit, Postnet Suite 235, Private Bag X2600, Houghton, 2041, South Africa (E-mail: trauma@mweb.co.za).

The first 20% of the full text of this article appears below.

Impalement injuries make rare, if spectacular, appearances at trauma centers. We describe the successful management of a left-sided thoracic impalement injury after an ultralight aircraft crash.

Clinical summary

A 40-year-old man was taking off in an ultralight aircraft, which stalled and plunged to the ground. The tail boom broke off on impact and impaled him through the left side of the chest. Paramedics discovered the pilot fully conscious; no attempt was made to remove the boom, but specialized cutting equipment was necessary to shorten it for transport. On arrival the patient's breathing was rapid and shallow, and the systolic blood pressure was 90 mm Hg with a pulse rate of 135 beats/min. An intercostal drain was placed after a chest radiograph was performed, and the patient was transferred directly to the operating room without further investigative studies. He was positioned at the edge of the operating table (Figure 1), which enabled him to lie supine and a double-lumen endotracheal tube to be inserted. The patient was turned (Figure 2) and a generous posterolateral thoracotomy incision was made, . . . [Full Text of this Article]

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