Sunday, June 04, 2006

Horses are Strong Animals

If you can avoid it, don't get kicked in the face by a horse. Luckily the human face is a lot like an aluminum can. If you smash it it will collapse in stages.

A very nice gentleman walked behind his horse at the wrong time the other day. He came in to the ED completely F'ed up with his lower lip shredded and unable to move his jaw. I knew looking at him that he had multiple mid-face fractures. Our institution does not have the latest CT technology and I didn't want to scan him if we were going to have to send him to the trauma center anyway. I opted for the plain films first which, strangely enough, did not show any fractures. I didn't believe what I was not seeing and I asked our radiologist to look at them as well. We agreed to do a CT scan, and there they were, this poor guy had fractured from his mid-face extending into his hard palate. I sent him to the specialist down the road and he was probably heading for the OR for a relatively complicated procedure.

The frustrating thing about this case for me is that we have group of Oral-Maxillofacial surgeons right down the road from us but they gave up their hospital privileges and will not talk with us. Why? Turns out they don't like being forced to work for free. Priveleges at the hospital mean call at the hospital which means non paying patients etc... I don't blame them.


  1. Ugh.
    I got kicked by a dead horse during my large animal necropsy rotation (I'm a small animal vet now). I will never forget it. I was making an approach to disarticulate the hip, as the horse was lying in lateral recumbency. I made an incision basically as deep as I could with the scalpel blade I was holding, and as I cut through the superficial part of the muscle, I triggered some kind of contraction and the whole leg kicked out at me. Luckily I fell backwards and bruised my ass instead of breaking my leg.

  2. ow!
    That must have hurt.