Citation

Lartizien R, Schouman T, Raux M, Debelmas A, Lanciaux-Lemoine S, Chauvin A, Toutee A, Touitou V, Bourges JL, Goudot P, Bertolus C, Foy JP. Lancet 2019; 394(10197): 469-470.

Affiliation

Department of Maxillo-Facial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, F-75013, France. Electronic address: jean-philippe.foy@aphp.fr.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/S0140-6736(19)31764-7

PMID

31402026

Abstract

Since November, 2018, France has been facing violent contestation with the national so-called yellow vests protests, resulting in about 4000 casualties.1 We managed 21 patients who presented with face and eye injuries caused by rubber bullets from non-lethal hand-held weapons (NLHHWs). Because of the steady increase in the overall number and violence of protests worldwide,2 one might expect a rise in injuries caused by NLHHWs.

Facial injuries related to NLHHWs share common characteristics, such as bone comminution and severe soft-tissue wounds, highlighting the high-velocity kinetic mechanism. Notably, we observed multifocal mandibular and dentoalveolar fractures, sometimes associated with transfixing wounds of the lip, and comminuted zygomatic fractures and orbital wall blow-out fractures, which were frequently associated with severe ocular traumatisms (figure). Most ocular injuries were extremely severe resulting in an initial visual acuity of less than 20/200 and an Ocular Trauma Score of 2 or less in half of the cases. We observed open-globe ruptures resulting in blindness, as well as severe closed-globe injuries such as choroidal detachment, and eyelid or lacrimal system lacerations. Intriguingly, postoperative infection or wound dehiscence was noted in four patients (19%)...

Language: en