PMC6018289_01
Preoperative clinical appearance
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F1
The shattered helmet has produced multiple splinters which produced a destructive type of injury with lodgments at different parts of the body [Figure 1].
Penetrated injury of face
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F2
E3V3M4 maintaining oxygen saturation of 92% and blood pressure of 110/60 mmHg. Examination revealed laceration from the left side of chest, severe edema of face with laceration on medial aspect of the right eye with loss of vision [Figure 2], and extensive lacerations over the left side of cheek and angle of mandible.
Preoperative radiograph showing fracture of mandible body and penetrated splinter
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F3
Computed tomography scan and posteroanterior view skull radiograph revealed a homogenous radiopaque mass superimposing the sphenoidal sinus and multiple radiopaque masses at the angle of mandible suggestive of splinters [Figure 3].
Exposure of the fracture in the mandible
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F4
As the fracture was severely comminuted, a submandibular approach was used and exposure of the fracture fragments along with the splinters was done [Figure 4].
Fixation of fracture segments
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F5
Splinters were removed and reconstruction of the continuity of the lower border of the mandible was done using reconstruction plate and miniplate [Figures 5 and 6].
Retrieved metallic splinter from the ethmoidal region and sphenoid sinus
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F6
Splinters were removed and reconstruction of the continuity of the lower border of the mandible was done using reconstruction plate and miniplate [Figures 5 and 6].
Postoperative view after 3 months
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F7
Individual was under regular follow-up postoperatively and was rehabilitated with ocular prosthesis on the right side by the prosthodontic team of our institute [Figure 7].