Table 1. Patient treatment data of the bear mauling cases.

Serial No.	Age (yr)/sex	Soft tissue	Hard tissue	Major injuries to other regions	Treatment and reconstruction used	Complication	Management
1	50/M	Multiple lacerations with a 4×4 cm scalp defect	# RT Le fort II maxilla	-	Rotational advancement flap and two point fixation of maxilla	Paresthesia over RT infraorbital nerve region	Full recovery after 5 mo
2	40/M	Multiple soft tissue lacerations	# RT Le fort I maxilla	# RT elbow joint	ORIF with trans-osseous wire fixation and primary closure	-	-
3	60/M	Multiple lacerations on the scalp and face	Comminuted # LT body region mandible	-	IMF and primary closure	Mild paresthesia over LT lower lip	Full recovery after 3 mo
4	4/M	Laceration of the chin	# LT condyle mandible	-	IMF (3 wk)	Mildly restricted mouth opening	Adequate mouth opening after 2 mo of physiotherapy
5	32/M	Multiple lacerations on the face	# Bilateral parasymphysis and # LT angle of mandible	-	ORIF (miniplate)	-	-
6	42/M	Pinna injury with a 10-cm long laceration	# RT body mandible and RT zygomatic arch	-	ORIF (miniplate) and pinna repair	Hypertrophic scar	Scar revision
7	25/M	Two lacerations on face and neck region	Comminuted # symphysis and LT parasymphysis mandible	-	IMF for 6 wk	Mild restriction on mouth opening	Active jaw exercise for 1 mo
8	45/M	Loss of RT ala of nose	# Nasal bone	-	Reconstruction with auricular cartilage and forehead flap	Flattening of nasal bridge	Patient refused corrective rhinoplasty
9	34/M	Multiple lacerations on the LT cheek	# LT ramus and RT parasymphysis mandible	-	ORIF (trans-osseous wiring) primary closure	-	-
10	41/M	Laceration in the RT temporal region	# RT ZMC	-	ORIF (one point fixation)	Mild enopthalmus	Patient refused further treatment
11	20/M	Laceration on the LT angle mandible	# LT angle mandible	-	IMF for 6 wk	Mild restriction on mouth opening	Overcome with physiotherapy
12	48/M	Skin loss on the LT cheek and submandibular region about 5×5 cm	Bone loss from RT parasymphysis to LT angle mandible (11 cm)	-	Free fibula osteocutaneous free tissue transfer	Mild dehiscence at the trifurcation point	Revised suturing
13	40/F	Multiple lacerations on the	# LT ZMC	Loss of vision of LT eye, LT elbow joint fracture	Exenteration of LT eye and ORIF	Patient lost to follow-up	-
14	50/M	Loss of RT cheek tissue 6×7 cm (width×length)	# RT zygomatic arch	-	ORIF and anterio-lateral thigh free tissue transfer	Mild excess thickness over zygomatic arch region	Patient was happy and unwilling to undergo further revision.
15	45/M	Lacerations on the scalp and face	# LT parasymphysis and RT body mandible	-	ORIF	-	-
16	42/M	Laceration of the parotid region about 10 cm in length	-	-	Primary closure	-	-
17	39/M	Multiple lacerations on the face and scalp	# RT ZMC and nasal bridge	-	ORIF for ZMC # and conservative management for nasal fracture	Mild depression at nasal bridge	-
18	48/M	Multiple lacerations on the face and scalp	Pan-facial fracture including frontal, zygoma and loss of anterior maxilla	-	ORIF and maxillary palatal plate	Palatal fistula	Fistula closure by palatal flap
19	60/M	Multiple lacerations on the forehead and scalp with soft tissue loss of RT zygomatic region 6×10 cm (width×length)	Le fort II maxilla with RT ZMC fracture	Vision loss in RT eye	Exenteration of RT eye, ORIF and radial forearm free tissue transfer for soft tissue coverage	-	Patient refused prosthetic replacement of eye
20	56/M	Multiple lacerations on the face and forehead	Non-displaced # frontal bone	Vision loss in RT eye	Exenteration of eye and primary closure	-	Prosthetic rehabilitation

(M: male, F: female, #: fracture, RT: right, LT: left, ORIF: open reduction and internal fixation, IMF: intermaxillary fixation, ZMC: zygomatic complex fracture)