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.
Key-words:
Craniofacial injury - debridement craniectomy - complications - winnower fan blade
injury
