The Big Bang: Facial Trauma Caused by Recreational Fireworks

Abstract

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.

Keywords: blast injuries; facial trauma; firework injuries; fireworks; reconstruction.

Fig. 1

Severe facial soft-tissue injury after firework blast to the face in patient 1.

Fig. 2

Preoperative computed tomography scan of patient 1, coronal and transversal plane, respectively.

Fig. 3

Postoperative three-dimensional computed tomography reconstruction image of patient 1 after reconstructive surgery.

Fig. 4

Clinical photograph of patient 1 after the reconstructive surgeries. Drooping of the right corner of the mouth is seen due to facial nerve injury.

Fig. 5

Preoperative three-dimensional reconstruction image (left) and computed tomography scan (right) of patient 2.

Fig. 6

Clinical photograph of patient 2 after evisceration of the right eye.

Fig. 7

Postoperative three-dimensional reconstruction image (left) and computed tomography scan (right) of patient 1 after reconstructive surgery, coronal plane (above) and sagittal plane (below).

Fig. 8

Clinical photograph of patient 2 after reconstructive surgery of the right orbital floor and a correction of an entropion.