공압식 못총에 의한 두부외상

초록

목적 : Accidents with a pneumatic nail gun, which has been used in the construction industry, have increased. However, reports on management of a patient with a nail gun injury to the cranium are rare. The authors report on a case of a patient treated with simple retraction after small skin and prophylactic antibiotic administration. 대상및 방법 : A 56-year-old man had five nail gun-shots on his skull due to attempted suicide and was transferred to the emergency room. Because the nail head played a role as a brake, the launched nail made a hole in the skull but did not entirely pass through it. 결과 : All procedures were performed in the operating room under general anesthesia in order to treat the emergent condition as rapidly as possible. The nail head was located beneath the scalp and tightly attached to the skull, it was not visible from the outside. A small incision to advance a forcep and a rongeur was necessary, and then the nail head was extracted easily without resistance. In the same manner, all nails were removed successfully. 결론 : In the patient with head injury by pneumatic nail gun, the first evaluation should focus on the shape of the nail head and vascular integrity from simple X ray and CT. If the nail head is confined to the depth of skull penetration, cautious extraction of the nail head can be performed without postoperative complication and early start of prophylactic antibiotics can be the next treatment.