An Open Distal Radius Fracture Inflicted by a Bear Mauling: A Case Report and Literature Review.

Abstract

Contact with bears has become more frequent, as have the resultant maulings. Herrero et al.1 showed a positive linear relationship between the number of fatal bear attacks per decade and human population size in the United States and Canada per decade. Studies on human injury as a result of bear maulings are few, and orthopaedic management of open fractures caused by such attacks is rarely reported. It is known that infection is the most common and devastating complication of open fractures, and this complication rate is increased even more with an animal attack because of the potential for microbial contamination from claws, teeth, and the environment2. It is well documented that injuries from large attacking animals may lead to deep infection as a result of substantial soft-tissue wounds that are contaminated with a variety of pathogens3. To complicate matters, many animal attacks occur in remote wilderness areas, and there are substantial delays in notification, rescue, and presentation to definitive care treatment centers4. We present a patient who sustained an open fracture of the distal part of the radius as a result of a black bear (Ursus americanus) mauling. We also review the literature on orthopaedic injuries associated with bear maulings. We followed a standard protocol for the management of open fractures with this patient, which eventually led to a good result. The patient was informed that data concerning the case would be submitted for publication, and he provided consent. A fifty-four-year-old man presented to the trauma center following an attack by a large black bear while hunting. The initial attack occurred approximately sixty to ninety minutes prior …