[SavageGlow]

A 29-year-old man endured facial trauma when he was directly hit by recreational fireworks in the night of January 1st, 2011. The patient was taken to the emergency department and was managed according to the Advanced Trauma Life Support protocol. The patient presented with a compromised airway because of serious bleeding from extensive soft-tissue injury. He was intubated immediately with an endotracheal tube with sedative etomidate and paralytic agent succinylcholine.

The patient was hemodynamically stable, however, had severe soft-tissue injuries to the right side of the face.
The extensive trauma prevented adequate examination of vision and sensibility of the face. Computed tomography (CT) angiography of the face, cranium and neck were performed which showed multiple fractures including:

Communtive fracture of the mandible
Le Fort 2 fracture
Midline fracture of the maxilla
Extensive fractures of the walls of the right maxillary sinus; right and left orbital floor
Right zygomatic arch fracture
Fracture of right temporal bone at the temporomandibular joint
In addition, small hyperdense and spherical bodies which are remnants of explosive powder were also found. An angiography was also performed with findings of an arterial bleeding on the right side of the face. However, there were no signs of intracranial or cervical injuries. Oral and maxillofacial surgery, ophthalmology, and plastic surgery were consulted. The patient was brought to the operation room soon after presentation.

During extensive debridement, the plastic surgeons found large defects of facial musculature in the buccal region. In addition, lesions of the facial nerve and parotid duct were also encountered. The facial artery was clipped intraoperatively. Much of the explosive powder residue was removed. The oral and maxillofacial surgeons approached the fractures of the mandible and maxilla through oral incisions, after the oral endotracheal tube and nasopharyngeal tube were replaced.

The fractures were further reduced and fixated using titanium plates. The parotid duct was finally sutured back into the buccal mucosa and the soft tissue was closed.

Postoperative care
The patient was kept under observation in the intensive care unit. The patient was discharged with no postoperative complication on the 9th day after presentation. However, he had to be readmitted on the 14th day post trauma because he developed a wound dehiscence in the buccal region in association with an orofacial fistula. The defect was closed by the plastic surgeon using a supraclavicular artery island flap 33 days after the incident. Similarly, multiple scar corrections were performed at 16 and 20 months to correct mutilating scars in the face and trismus.

[marcos_69]

Fuck, looks like he was shot with a cannon.

[SavageGlow]

Originally Posted by marcos_69 ↗

Fuck, looks like he was shot with a cannon.

I often wonder at the fireworks they're using?

I've only seen dinky little ones.

[kellyhound]

Originally Posted by Kimmie ↗

I often wonder at the fireworks they're using?

I've only seen dinky little ones.

Was a rocket. more info and another case:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858422/

[SavageGlow]

Originally Posted by kellyhound ↗

Was a rocket. more info and another case:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858422/

Thanks!

[Caf002]

I’d say he’s damn lucky they were able to put his face back together!

[Mr.NoCredit]

Originally Posted by kellyhound ↗

Was a rocket. more info and another case:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858422/

Your username is very appropriate Kelly *Hound…. You find things like no other when you want to.

[LadyCPlum]

Damn, they did a pretty good job of putting Humpty Dumpty back together again!

[Trucked up]

That's what too many of those black snakes lit at the same time can do, that's the result of venom.