Functional Reconstruction Following Maxillofacial Trauma from a Hippopotamus Bite: Challenges and Management

Abstract

Animal bite injuries are a common cause of emergency trauma, while wild animal bites are rare but associated with high morbidity due to severe mechanical damage and polymicrobial contamination. We report a rare case of a hippopotamus bite causing complex maxillofacial, thoracic, abdominal, and gluteal injuries in a 58-year-old zoo caretaker. Clinical and radiologic evaluation revealed a displaced mandibular ramus fracture with extensive soft-tissue trauma. Early multidisciplinary management included wound debridement, rabies and tetanus prophylaxis, chest drainage for hemo-thorax, and planned multidisciplinary surgical intervention. Open reduction and internal fixation of the mandible achieved complete functional recovery. Microbiological cultures demonstrated polymicrobial infection, necessitating targeted antibiotic therapy. No long-term complications occurred. This case highlights the aggressive nature of hippopotamus bite injuries, the potential for complex infection patterns, and the importance of prompt, coordinated multidisciplinary care in achieving favourable outcomes.