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An Open Distal Radius Fracture Inflicted by a Bear MaulingA Case Report and Literature Review
Corey S. Rosenbaum, DO1; Michael Suk, MD, JD, MPH2; Brett Puckett, MD1
1 University of Florida-Jacksonville, 655 West 8th Street, ACC Building, 2nd Floor/Ortho, Jacksonville, FL 32209. E-mail address for C.S. Rosenbaum: Corey.rosenbaum@jax.ufl.edu. E-mail address for B. Puckett: brett.puckett@jax.ufl.edu
2 Department of Orthopaedic Surgery, Geisinger Health System, 100 North Academy Road, MC 21-30, Danville, PA 17822. E-mail address: msuk@geisinger.edu
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Investigation performed at the University of Florida, Jacksonville, Florida

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Aug 14;3(3):e79 1-4. doi: 10.2106/JBJS.CC.L.00227
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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.
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