Penetrating pencil injury: an unusual case of child abuse.
OBJECTIVE
We report an unusual case of penetrating pencil injury in a young child that turned out to be a case of physical abuse.


METHODS
This is a case report with review of the literature.


RESULTS
A 4-year-old boy was brought by his mother to the accident and emergency department for a penetrating wound of the right hand. He was said to have injured himself during a fall at home while holding a sharpened lead pencil. The pencil broke after penetrating the hypothenar eminence, leaving the graphite tip embedded in the palm. On surgical exploration, a piece of graphite measuring 1.3 cm was removed. The injury was actually inflicted by his mother because he failed to complete his homework properly. Deep penetrating injuries associated with the lead pencil are uncommon events in the medical literature. They are often reported as accidental and usually involve the oropharynx and the orbit.


CONCLUSIONS
Deep penetrating injury with a pencil is unusual in childhood and the public should be made aware of the possibility of nonaccidental injury.
Department of Pediatrics, Tuen Mun Hospital, New Territories, Hong Kong.
A C
AC
Lee
K T
KT
So
H L
HL
Wong
S
S
Lau
D002649:Child Abuse / Q000175:diagnosis*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005547:Foreign Bodies / Q000175:diagnosis*; D006108:Graphite; D006230:Hand Injuries / Q000175:diagnosis*; D006801:Humans; D008297:Male; D014950:Wounds, Penetrating / Q000175:diagnosis*
D006108:Graphite