Asian Journal of Case Reports in Surgery

Penetrating injuries of the lower limb from unusual foreign bodies are uncommon and can be alarming at presentation, especially when the object lies close to important neurovascular structures. We present the case of a 62-year-old female patient who presented 3 hours after being struck by a scooter while crossing the road. On arrival, she had a scooter kick lever visibly impaled in her right lower leg, approximately 4–5 cm above the ankle. She complained of significant pain and bleeding and was unable to bear weight. Despite the dramatic presentation, clinical examination was reassuring, with palpable distal pulses and intact motor and sensory function. Only mild bleeding was noted from the entry and exit wounds. An X-ray confirmed that the metallic foreign body was lodged between the tibia and fibula, with no associated fracture. Given its close proximity to major vessels, a CT angiography was performed to exclude vascular injury, which showed no compromise. The patient was taken up for surgery under general anaesthesia. The foreign body was carefully removed, followed by wound exploration and thorough debridement. The wounds were left open with stay sutures to allow for healing and monitoring, and intravenous antibiotics were administered. The postoperative recovery was smooth. With regular dressings, the wound showed healthy healing, and the patient gradually regained full function of the limb without any complications. This case illustrates how even striking and unusual injuries can have favourable outcomes when approached systematically. Careful clinical assessment, appropriate imaging, and timely surgical intervention remain key to ensuring safe and effective management in such rare presentations.