Sledge Hammer Impalement: a case report of challenges of managing a patient with a heavy pendant.

Introduction: Impalement injuries are well defined. Transfixion injuries involve impalement and are defined in terms of fixation usually to a large object.

Case Report: We report a spectacular case of sledge hammer impalement in the neck where the patient was transfixed, albeit to a small object, requiring movement of the patient and the transfixing object as a single unit.