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A review of upper limb injuries in bear maul victims: Consistent pattern and inverse relation in severity with facial and scalp injuries
Authors:Towseef Ahmad Bhat  Amara Gulzar  Aejaz Ahmad Bhat  Tariq Ahmad Bhat  Zameer Ali
Affiliation:1. Department of Orthopaedics, Pt. Jawahar Lal Nehru Govt. Medical College, Chamba, Himachal Pradesh, India;2. Department of Emergency Medicine, SKIMS Medical College, Bemina, Srinagar, India;3. Physical Medicine, Govt. Medical College, Srinagar, India;4. Department of Orthopaedics, Govt. Sub District Hospital Chadora, Srinagar, India;5. Department of Orthopaedics, New City Hospital, Srinagar, India
Abstract:

Purpose

Bear maul injuries are the most common wild animal inflicted injuries in India. More than 300 bear maul injuries report to our hospital per year.

Methods

Twenty-one consecutive patients over a period of 1 year reported to our department for orthopaedic management of bear maul injuries. All the patients were referred either from peripheral hospitals or from other surgical departments of our hospital.

Results

All the patients had facial/scalp injuries of variable severity. In all the patients the severity of limb and facial trauma was inversely proportional to each other. Pattern of upper limb trauma in most of the patients was similar. Fifteen patients had either fractures of distal humerus or mid shaft/proximal forearm bone fracture. Two had distal forearm bone fracture, 2 had carpal/metacarpal fractures and 1 had clavicle fracture. Only 1 had lower limb fracture. Thirteen out of 21 patients had associated neurovascular injury of the involved limb. The characteristic feature was extensive soft tissue involvement of the affected limb.

Conclusion

Upper limb injuries in bear maul patients usually have similar pattern. The severity of upper limb and facial/scalp trauma is inversely proportional to each other. Multistage orthopaedic surgeries are needed for such complex limb injuries.
Keywords:Bear maul  Upper limb fractures  Facial  Scalp
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