A non-fatal impalement injury of the thorax

Impalement is an uncommon injury with only occasional reports in the litera ture. There are even fewer reports of impalement injuries limited to the th orax;. We report herein the case of a 24-year-old man who survived impaleme nt injury of the left side of the thorax with a steel rod while working at a construction site. The great vessels of the thorax were spared but the se cond thoracic vertebra was fractured resulting in complete paralysis of the left lower Limb. The precise nature and extent of the injury were determin ed pre-operatively by computed tomography and aortography. The important pr inciples of surgical management contributing to the successful outcome are described, these being minimal manipulation of the impalement object before and during transport, careful pre-operative planning and a multidisciplina ry approach.