Complex Craniofacial Trauma Resulting From Fireworks Blast

CT Findings of Firework Injuries to the Head and Neck

OBJECTIVES

The purpose of this study is to review the CT imaging findings of injuries in the head and neck caused by fireworks through a case series.

METHODS

The imaging database from the University of Chicago Medicine was searched with "fireworks," "firecrackers," and "mortar" as keywords and CT as the imaging modality. Cases without acute CT findings or initial CT scans were excluded.

RESULTS

Eighteen cases with acute CT findings of head and neck firework injuries were identified and included. The associated injuries included skull fractures (5, 28%), ocular injuries (7, 39%), soft tissue trauma (18, 100%), retained foreign bodies (8, 44%), and intracranial trauma (2, 11%).

CONCLUSIONS

Fireworks can cause injuries of varying severity in the head and neck, including blunt and penetrating trauma, that warrant CT evaluation.

Feel the Burn! Fireworks-related Otolaryngologic Trauma

OBJECTIVES

Fireworks are used commonly for celebrations in the United States, but can lead to severe injury to the head and neck. We aim to assess the incidence, types, and mechanisms of head and neck injuries associated with fireworks use from 2010 to 2019.

METHODS

A retrospective cross-sectional study, using data from the National Electronic Injury Surveillance System, of individuals presenting to United States Emergency Departments with head and neck injuries caused by fireworks and flares from 2010 to 2019. Incidence, types, and mechanisms of injury related to fireworks use in the US population were assessed.

RESULTS

A total of 541 patients (349 [64.5%] male, and 294 [54%] under 18 years of age) presented to emergency departments with fireworks-related head and neck injuries; the estimated national total was 20 584 patients (13 279 male, 9170 white, and 11 186 under 18 years of age). The most common injury diagnoses were burns (44.7% of injuries), laceration/avulsion/penetrating trauma (21.1%), and otologic injury (15.2%), which included hearing loss, otalgia, tinnitus, unspecified acoustic trauma, and tympanic membrane perforation. The remaining 19% of injuries were a mix, including contusion, abrasion, hematoma, fracture, and closed head injury. Associations between fireworks type and injury diagnosis (chi-square P < .001), as well as fireworks type by age group (chi-square P < .001) were found. Similarly, associations were found between age groups and injury diagnoses (chi-square P < .001); these included children 5 years and younger and adults older than 30 years.

CONCLUSIONS

Fireworks-related head and neck injuries are more likely to occur in young, white, and male individuals. Burns are the most common injury, while otologic injury is a significant contributor. Annual rates of fireworks-related head and neck injuries have not changed or improved significantly in the United States in the past decade, suggesting efforts to identify and prevent these injuries are insufficient.

The Big Bang: Facial Trauma Caused by Recreational Fireworks

In the Netherlands, it is a tradition of setting off fireworks to celebrate the turn of the year. In our medical facility, each year patients with severe skeletal maxillofacial trauma inflicted by recreational fireworks are encountered. We present two cases of patients with severe blast injury to the face, caused by direct impact of rockets, and thereby try to contribute to the limited literature on facial blast injuries, their treatment, and clinical outcome. These patients require multidisciplinary treatment, involving multiple reconstructive surgeries, and the overall recovery process is long. The severity of these traumas raises questions about the firework traditions and legislations not only in the Netherlands but also worldwide. Therefore, the authors support restrictive laws on personal use of fireworks in the Netherlands.

[Rare mechanisms of blowout fractures. Discussion of two case reports]

In the emergency room different forms of traumata with resulting insulating orbital blowout fracture are observed. The cause of accident is almost always impact to the central face with a solid object or on a hard surface. The hydraulic pressure theory and buckling force theory in terms of the pathomechanism are valid and accepted explanation models. We report two clinical cases of unusual injury mechanisms, which we discuss with reference to the available literature.