title: Retained weapon injuries: experience from a civilian metropolitan trauma service in South Africa.
abstract: BACKGROUND
  Retained weapon (RW) injuries are uncommon, but there is no current consensus on the best management approach.
  
  
  METHODS
  We reviewed our experience of 102 consecutive patients with non-missile RWs in a high-volume metropolitan trauma service managed over a 10-year period.
  
  
  RESULTS
  Of the 102 patients, 95 were males (93%), 7 were females (7%), and median age was 24 (21-28) years. Weapons: 73% (74/102) knives, 17% (17/102) screwdrivers, 5% spears, 6% (6/102) others [axe (1), glass fragment (1), stick (1), sickle blade (1), wire (1) and stone (1)].
  
  
  METHODS
  8% (8/102) head, 20% (20/102) in the face, 9% (9/102) neck, 14% (14/102) thorax, 25% (26/102) abdomen, 23% (23/102) upper limb, 2% (2/102) lower limb. Four per cent (4/102) were haemodynamically unstable and proceed immediately to the operating theatre for operative exploration and weapon extraction. Imagining: 88 (86%) plain radiographs, 65 (64%) non-contrast CT scans, 41 (40%) contrast CT angiography, 4 (4%) formal angiography. Seventy-two underwent simple extraction, and 29 underwent extract plus open operation. One patient absconded. Specialist surgeons involved in extraction: trauma surgeons (74), neurosurgeons (10), ophthalmic surgeons (11) and ENT surgeons (4). Overall, 92% (94/102) survived to discharge.
  
  
  CONCLUSIONS
  The vast majority of patients with RWs will be admitted in a stable condition and haemodynamic instability was almost exclusively seen in the anterior thorax. The most common site was the posterior abdomen. Detailed imagining should be used liberally in stable patients and unplanned extraction in an uncontrolled environment should be strongly discouraged.
authors.affiliation: Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, KwaZulu Natal, 3216, South Africa, victorywkong@yahoo.com.
authors.forename: V
authors.initials: V
authors.lastname: Kong
authors.forename: Z
authors.initials: Z
authors.lastname: Khan
authors.forename: S
authors.initials: S
authors.lastname: Cacala
authors.forename: G
authors.initials: G
authors.lastname: Oosthuizen
authors.forename: D
authors.initials: D
authors.lastname: Clarke
mesh_terms: D000328:Adult; D020212:Carotid Artery Injuries / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods*; D004632:Emergency Medical Services; D005260:Female; D005547:Foreign Bodies / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D014951:Wounds, Stab / Q000150:complications / Q000401:mortality / Q000601:surgery*