A 64-year-old construction worker who had penetrating trauma of the abdomen by two iron reinforcing rods at a construction site was transferred to our hospital in stable condition. Although it was difficult to differentiate the intraabdominal injuries, X-ray and CT findings suggested canal impaled injury at the L4 level, and fractures of left radial head (AO 21-A2) and right radial distal end (AO 23-B1). After stabilized the fractures by splint an emergency celiotomy was performed to remove one of bars penetrating the abdomen, which revealed no serious damage in the intraperitoneum. Then, the L4 laminectomy was performed. The second bar had caused the light dural injury to the left root of L4. After the bar was removed and the duramater repaired, the wound was irrigated copiously with saline solution. Gentamicin 120mg/day for 4 days and Ampicillin 3.0g/day for 8 days were administrated after surgery. Although no infection was observed following surgery, paresthesia in the left area of L4-5 and loss of muscular strength in the left lower leg appeared. The operation was performed against left radial head facture after 3 weeks. The patient was discharged 2 months after surgery with long leg brace, and one cane gait. He became able to walk with shoe brace 6 months after surgery. Interdepartmental teamwork was important to save the patient. Procedures adequate for the penetrating trauma are open the wound, irrigate copiously, and monitor the drainage system for signs of infection.
