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Attacked from a bear while grazing his cattle

A 35 year old male patient reported to emergency OPD with history of bear attack when he had gone to the jungle to graze his cattle. There was history of loss of consciousness for half an hour but no history of vomiting and ENT bleeding. On examination the patient was stable, neurological and cervical spine examinations were within normal limits. CT of the head was normal.

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Fig.1: Bear attack causing complex laceration of scalp, forehead and right peri-orbital tissue with fracture in left F–Z region.

From right frontal region, the laceration extended downward up to about 1 cm lateral to right corner of mouth. There was complex laceration of right periorbital soft tissues. Similarly, on left side also the laceration extended downward up to upper eyelid (Fig. 1a).

Under general anesthesia, after thorough irrigation with saline and wound debridement, fracture was reduced, miniplate fixation at F–Z region carried out (Fig. 2) and simultaneously primary wound repair was done.

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Fig 2: Performing ORIF with titanium miniplate at F–Z region.

Tetanus toxoid vaccine and antibiotic prophylaxis with amoxicillin–clavulanate were given. Posto-perative results were satisfactory (Fig. 3).

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Fig. 3: Immediate post-operatively after primary repair of wounds

Credit: Anjani Kumar Yadav