Orbital “shanking”: a unique prison injury

Abstract

The purpose of this paper is to describe orbitocranial penetration due to “shanking”, a common mode of assault in prison facilities. We report the case of a prisoner who presented with orbital apex syndrome 5 days after an assault. He died 9 days after surgical removal of the “shank” due to a presumed ruptured traumatic aneurysm. Physicians who evaluate prisoners must maintain a high index of suspicion for penetrating injuries. The entrance site is often inconspicuous and the history may be limited in this unique population.