Bull horn injuries.

Bull horn injury is not uncommon, and during a 12 year period from 1977 to 1988, 101 patients required inpatient treatment at the Christian Medical College Hospital, a teaching hospital at Vellore in South India. The ages of these patients ranged from two years to 90 years and the male to female ratio was 4:1. Sixty-one per cent of the injuries occurred either to the perineum or abdomen and wounds were directed obliquely upward. Thirty-five per cent required extensive surgical intervention. The over-all wound infection rate was 12.9 per cent. Of wounds that were primarily closed, 42.9 per cent had wound infection, while only 6.3 per cent that were secondarily closed developed infection. Two patients died as a consequence of the injury. Based on the results of this study, we recommend that a careful evaluation of the injury and timely and appropriate management of each patient must be done to reduce morbidity and mortality. Primary closure of wounds must be avoided even when surgical intervention is possible soon after injury.