case_images: PMC6018289_01
case_images: Preoperative clinical appearance
case_images: AMS-8-166-g001.jpg
case_images: PMC6018289_01_AMS-8-166-g001.jpg
case_images: F1
case_images: The shattered helmet has produced multiple splinters which produced a destructive type of injury with lodgments at different parts of the body [Figure 1].
case_images: Penetrated injury of face
case_images: AMS-8-166-g002.jpg
case_images: PMC6018289_01_AMS-8-166-g002.jpg
case_images: F2
case_images: 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.
case_images: Preoperative radiograph showing fracture of mandible body and penetrated splinter
case_images: AMS-8-166-g003.jpg
case_images: PMC6018289_01_AMS-8-166-g003.jpg
case_images: F3
case_images: 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].
case_images: Exposure of the fracture in the mandible
case_images: AMS-8-166-g004.jpg
case_images: PMC6018289_01_AMS-8-166-g004.jpg
case_images: F4
case_images: 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].
case_images: Fixation of fracture segments
case_images: AMS-8-166-g005.jpg
case_images: PMC6018289_01_AMS-8-166-g005.jpg
case_images: F5
case_images: 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].
case_images: Retrieved metallic splinter from the ethmoidal region and sphenoid sinus
case_images: AMS-8-166-g006.jpg
case_images: PMC6018289_01_AMS-8-166-g006.jpg
case_images: F6
case_images: 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].
case_images: Postoperative view after 3 months
case_images: AMS-8-166-g007.jpg
case_images: PMC6018289_01_AMS-8-166-g007.jpg
case_images: F7
case_images: 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].