Five years’ experience at a single centre of craniocerebral injury from winnowing fan blades

Kumar, Anil; Shankar, Ravi; Pandey, Rajendra; Keshri, Virendra; Singh, Kulwant; Sharma, Vivek

doi:10.1016/j.jocn.2009.05.011

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…The majority of the studies shows that adhering to principles such as early surgery, removal of contaminants from the wound, thorough debridement with dural repair (primary/ augmentation) during the primary treatment would give the maximum benefit and best possible results. [2,5] Like in many studies, the majority of the injuries in our patient occurred in the fronto-parietal and facial regions. Postoperative wound infections and the CSF leak are the two dreaded complications which add on to the prolonged hospital stay and morbidity in many studies.…”

Section: Discussionsupporting

confidence: 72%

“…and we attribute this to delay at presentation. [ 2 ] Despite the risk of fungal infection by the vegetable material, antifungal was not initiated in any of our case and all recovered well with just debridement and antibiotics alone. The majority of the western literature on compound depressed fracture describes clean wound status and hence are less likely to harbor foreign bodies.…”

Section: Discussionmentioning

confidence: 91%

“…[1] Kumar et al had >90% of craniocerebral injuries following winnower blade injuries in children of tender age 13 years or less with a mean age of 8 years. [2] Though the majority of our cases were nonfatal, the machine causes a significant degree of high velocity, sharp, deep penetrating injuries. [3,4] Associated strangulation resulting in possible ischemic damage was seen in two cases in our study which has not been reported before.…”

Section: Discussionmentioning

confidence: 96%

“…had >90% of craniocerebral injuries following winnower blade injuries in children of tender age 13 years or less with a mean age of 8 years. [ 2 ]…”

Section: Discussionmentioning

confidence: 99%

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Craniofacial trauma in pediatric patients following winnowing blade injury-review of literature

et al. 2018

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In developing countries, during the harvest season, winnower blade injuries occur very frequently in children and results in lifelong disability. Nine children were managed during 1 month, all resulting due to winnower blade induced craniofacial trauma. PubMed search for “fan blade injury” showed two case series and three case reports. In our study, 88% had compound depressed fracture; brain matter leak in 56%, cerebrospinal fluid (CSF) leak alone in 22%. 66.7% had injury involving the frontal bone. Two patients had eye injury with visual loss. Seven underwent debridement craniectomy, five augmentation duroplasty and three contusectomy. All had vegetable material, sand particles. Complications in 66.6% with two cases of CSF leak settled with lumbar drain, one case of CSF otorrohea, 22.2% of wound infection, 44.4% wound dehiscence requiring redebridement and suturing in five patients. Two patients had postoperative seizures, two patients had hemiparesis both improved. Two low Glasgow Coma Scale remained so on postoperative period. One case of subdural empyema needed debridement and duroplasty with glue. No mortality noted. These findings were consistent with previous reports. Follow-up at 1.5 months showed good functional recovery. Early surgery debridement, steps to minimize postoperative infections, identifying putative risk factors early in the management are the principles of a successful treatment regimen.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 96%

“…had >90% of craniocerebral injuries following winnower blade injuries in children of tender age 13 years or less with a mean age of 8 years. [ 2 ]…”

Section: Discussionmentioning

confidence: 99%

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Craniofacial trauma in pediatric patients following winnowing blade injury-review of literature

et al. 2018

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“…Farm machine-related injuries in children are common modality of head injury. [1][2][3] We describe here a case of threshing fan blade injury to head and its successful management.…”

Section: Introductionmentioning

confidence: 99%

Craniofacial Injury in a Child by Agricultural Fan Blade: A Case Report

Khan,

Anwer,

Kumar

et al. 2024

Indian Journal of Neurotrauma

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Farm machine-related injuries in children are common modality of head injury. We describe here a case of threshing fan blade injury to head and its successful management. A 10-year-old male was brought to the emergency department of All India Institute of Medical Sciences (AIIMS) Patna with the complains of accidental fall on the fan blade of the thresher machine. On arrival he had a Glasgow Coma Scale of E1VTM5 status, bilateral pupil mid-dilated and sluggish reaction to light. On secondary survey, he had a lacerated wound of size 15 × 4 × 2 cm extending from left side forehead to right temporal region exposing bone and brain parenchyma herniation through the wound. A noncontrast computed tomography head showed B/L frontal contusion with gross edema, subarachnoid hemorrhage, and intraventricular hemorrhage. There was fracture of bilateral frontal bone extending to right parietotemporal bone. Patient was taken to operating room, where after painting and draping, the wound was irrigated with normal saline. The herniated brain was removed, securing hemostasis with surgical and Bovie cautery. He underwent a prolonged neurorehabilitation and made a complete recovery after 3 months of injury. Bihar is an eastern part of India where agriculture plays a major role in rural livelihood. Winnowing fan machines are used to separate the grain from the husk. Children have peculiar behavior to inspect things and this curious behavior leads to coming in contacts with the open blade. Falling on even a stationary blade can sometimes lead to head injury. Early surgery with meticulous wound debridement and closure of dura is required. Covering the fan blade as well as careful parenting of children will prevent further injuries.

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The Evolution of Modern Treatment for Depressed Skull Fractures

Stein

2019

World Neurosurgery

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Five years’ experience at a single centre of craniocerebral injury from winnowing fan blades

Cited by 4 publications

References 13 publications

Craniofacial trauma in pediatric patients following winnowing blade injury-review of literature

Craniofacial trauma in pediatric patients following winnowing blade injury-review of literature

Craniofacial Injury in a Child by Agricultural Fan Blade: A Case Report

The Evolution of Modern Treatment for Depressed Skull Fractures

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