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服务过程中因轮胎轮辋意外爆炸导致粉碎性中三眶颧骨复合体骨折并失明——一例罕见病例。

Comminuted middle third orbito-zygomatic complex fracture leading to blindness due to unanticipated tyre rim explosion during service - A rare case.

机构信息

Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Science, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry, India.

出版信息

Indian J Dent Res. 2021 Apr-Jun;32(2):268-271. doi: 10.4103/ijdr.IJDR_652_18.

Abstract

An explosion is caused by conversion of solid, liquid into gas with resultant energy release. Blast injuries of large tyres are similar to injuries resulting from landmine explosions. Most of the patients were polytraumatised, initial evaluation and management should follow ATLS. Trauma following tyre blast results in severe soft tissue, orthopedic and head injuries. Head and face is the most commonly affected region followed by upper limb. A 40 year old male patient was watching a car tyre getting inflated with air. Unfortunately the tyre rim exploded on his face, which led to penetrating injury to the eye ball and comminuted middle third fractures. Patient was stabilized and primary hemostasis was achieved. Fractured maxilla was fixed by arch bar wiring and stabilized by using circum-suspension wiring bilaterally. Left eyeball was removed due to open globe injury and intraocular content loss. Unusual maxillofacial injuries are more common. Decision making and treatment of facial penetrating injuries depends on number of factors, which includes location and extent of injury, type of foreign body involved, proximity of vital structures, extent of injury to soft and hard tissue and the relative benefits and risk ratio for the patient. In this case report we have explained about the primary assessment and management of blast injuries.

摘要

爆炸是由固体、液体转化为气体而产生的能量释放引起的。大型轮胎的爆炸损伤与地雷爆炸造成的损伤相似。大多数患者均为多发伤,初始评估和管理应遵循 ATLS 原则。轮胎爆炸后的创伤会导致严重的软组织、骨科和头部损伤。头部和面部是最常受影响的区域,其次是上肢。一名 40 岁的男性患者正在观看汽车轮胎充气。不幸的是,轮胎轮辋在他的脸上爆炸,导致眼球穿透伤和中间三分之一粉碎性骨折。患者得到稳定并进行了初步止血。通过拱形条带布线固定上颌骨骨折,并通过双侧环扎布线进行稳定。由于开放性眼球损伤和眼内容物丢失,左眼眼球被切除。不常见的颌面损伤更为常见。面部穿透伤的决策和治疗取决于多个因素,包括损伤的位置和程度、涉及的异物类型、与重要结构的距离、软硬组织损伤的程度以及对患者的相对获益和风险比。在本病例报告中,我们解释了爆炸伤的初步评估和管理。

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