An 18-year-old male from Salt Lake, Kolkata, sustained a severe impalement injury on February 7, 2026, after falling onto a spike-topped iron gate at his residence. He was admitted to Narayana Health–RN Tagore International Institute of Cardiac Sciences, where the hospital team executed a carefully planned extraction and surgical management strategy.
On the afternoon of February 7, just days before his examinations were scheduled to start, the teenager climbed onto the terrace parapet of his four-storey residence to check if the water tank had filled. While inspecting the rooftop water tank at the residential complex, he lost his footing and fell onto the spike-topped gate.
Two spear-shaped rods pierced through the 18-year-old's left wrist and palm, leaving a portion of the metal gate attached to his limb. He was transported to Narayana Health–RN Tagore International Institute of Cardiac Sciences for emergency care.
As reported by The Telegraph,
The gate’s pointed rods pierced my arm and I hung there for a brief period. Then the gate broke and I fell on the ground, stuck to the gate.
18-year-old, Patient
A multidisciplinary team of doctors, engineers, and technical staff planned and executed a controlled extraction of the metal structure, followed by surgical removal of the embedded spikes and management of associated injuries.
Upon arrival, clinicians evaluated the patient’s vital signs and performed a focused limb assessment. This included checking distal pulses, capillary refill, motor function, and sensation to determine vascular and neurological integrity. Imaging studies are commonly used in such injuries to assess bone involvement and the trajectory of penetration.
The size and rigidity of the iron gate presented a technical challenge. Standard surgical instruments were insufficient to detach the large external structure safely. The treating team therefore consulted biomedical engineers and hospital maintenance staff to develop an extraction strategy.
The technical team first proposed cutting the gate using a hacksaw, as they were more accustomed to handling that tool.
Dr. Surya Udai Singh, Orthopedic Surgeon at Narayana Health-RN Tagore International Institute of Cardiac Sciences told The Telegraph,
We got a hacksaw, but then the mechanics and engineers present said it would not work. So, we got an electric cutter.
Dr. Surya Udai Singh, Orthopaedic Surgeon, Narayana Health-RN Tagore International Institute of Cardiac Sciences
Meanwhile, doctors arranged for 20 bottles of saline to be cooled in a refrigerator and kept a fire extinguisher ready as a precaution. The team required approximately 10 minutes to separate the metal gate from the embedded spearheads.
When metal is cut with a cutter, a lot of heat is generated and it also triggers sparks. This would have burnt the boy’s arm. At the same time, it was impossible to remove such a large portion of metal from the hand on the operating table.
Dr. Surya Udai Singh, Orthopedic Surgeon, Narayana Health-RN Tagore International Institute of Cardiac Sciences
The team selected an electric metal-cutting device to separate the gate from the embedded spikes. High-speed cutting tools generate heat and sparks, which can cause secondary thermal injury to surrounding tissues.
To mitigate this risk, the team continuously irrigated the area with chilled sterile saline to dissipate heat. They also applied fire-extinguisher foam locally to suppress sparks and reduce thermal transfer. Once the external gate frame was removed, surgeons transferred the patient to the operating theatre.
Under anesthesia, orthopedic surgeons carefully extracted the remaining metal spikes from the wrist and palm. They inspected the wound for structural damage and performed necessary surgical repair.
The fall also caused a fracture of the patient’s right arm. Surgeons performed a separate procedure to stabilize the fracture. During his hospital stay, he received blood transfusion support. The team planned a skin graft to facilitate soft tissue coverage and wound healing.
Penetrating trauma carries a risk of infection. Standard management includes wound debridement, antibiotic therapy, and tetanus prophylaxis as indicated.
(Rh/SS/MSM)
