Orbitary fracture caused by rubber project: Case report





Orbit; Orbital fractures; Facial injuries; Penetrating cranial injuries.


Rubber projectiles are used, usually by police and private security entities, in the search for better control of demonstrations, riots or rebellions. Considered less lethal weapons than firearms, such devices can cause devastating bodily injuries, with aesthetic, functional and social consequences unimaginable to the target. The use of this instrument must follow recommendations carefully in order to avoid and / or minimize damage. The ballistic injuries that affect the maxillofacial region are a challenge for the buccomaxillofacial surgeon, due to its high degree of complexity, and anatomical identification of the damaged tissues, understanding of the limitations of this type of injury, the preservation of skeletal tissues and soft. Thus, awareness of the harmful potential of this instrument should be a priority in the quest to minimize injuries arising from it. The purpose of this article is to report the clinical case of an orbital fracture caused by a rubber projectile, as well as to discuss the morbidity potential of this instrument.


Amaral, M. B. F., Bueno, S. C., Abdala, I. B. et al. (2017). Fraturas faciais causadas por armas de bala de borracha menos letais: relatório da série de casos e revisão da literatura. J Craniomaxillofac Surg. 21: 357- 361.

Amelot, A., Goutagny, S., Ricome, S. & Peyre, M. (2013). Penetratring crânio cerebral injury cause by a rubber bullet question there lative harm lessness of the weapons. Am J Emerg Med. 31: 636e5- 636e7.

Burnstine, M. A. (2002). Clinical recommendations for repair of isolated orbital floor fractures: An evidence-based analysis. Ophthalmology. 109(7):1207–1210.

Colombo, L. R. C., Calderony, D. R., Rosim, E. T. & Passari, L. A. (2011). Biomateriais para reconstrução da órbita: Revisão de literatura. Rev.Bras.Cir.Plast. 26(2):337-344.

Cruz, C. C. Chumbo fino. O Estado de São Paulo. http://www.estadao.com.br/noticias/geral,chumbo-fino,843582.

El-Hadad, C., Deschenes J. &mArthurs, B. (2021). Orbital floor fracture. Cmaj. 193(8):289.

Fonseca, R. J., Barber, H. D., Walker, R. V., Powers, M. P. & Frost, D. E. (2015).Trauma Bucomaxilofacial. (4a ed.), Elsevier.

Gart, M. S., & Gosain, A. K. (2014). Evidence-based medicine: Orbital floor fractures. Plastic and Reconstructive Surgery. 134(6):1345e–1355e.

Gosau, M., Schoneich, M. Draenert, F. G., et al. (2011). Retrospective analysis of orbital floor fractures-complications, outcome, and review of literature. Clinical Oral Investigations. 15(3):305–313.

Haar, R. J., Iacopino, V., Ranadive, N., et al. (2017). Death, injury and disability from kinetic impact projectiles in crowd-control settings: A systematic review. BMJ Open. 7(12):1–10.

Hartwig, S.,Nissen, M. C., Voss, J. O., et al. (2019). Clinical outcome after orbital floo,r fracture reduction with special regard to patient’s satisfaction. Chinese Journal of Traumatology - English Edition. 22(3):155–160. https://doi.org/10.1016/j.cjtee.2019.01.002.

Holtmann, H., Eren H., Sander K., et al. (2016). Orbital floor fractures - short- and intermediate-term complications depending on treatment procedures. Head and Face Medicine. 12(1):4–9. http://dx.doi.org/10.1186/s13005-015-0096-3.

Ifantides, C., Deitzd, G. A., Christopher, K. L., et al. (2020). Less-Lethal Weapons Resulting in Ophthalmic Injuries: A Review and Recent Example of Eye Trauma. Ophthalmology and Therapy. 9(3) https://doi.org/10.1007/s40123-020-00271-9>.

Khonsari, R. H., Fleuridas, G., Arzul, L., Lefevre, F., Vincent, C. & Bertolus, C. (2010). Severe facial rubber bullet injuries: Less lethal but extremely harm ful weapons. Injury. 41: 73–76.

Kobayashi, M. & Mellen, P. F. (2009). Rubber Bullet Injury: Case Report with Autopsy Observation and Literature Review. Am J Forensic Med Pathol. 30(3):262-267.

Lavy, T., &Asleh, A. S. (2003). Ocular rubber bullet injuries. Nature, 17:821–824.

Mendes, P. S. P. Bala de Borracha. Repositório Institucional UFSC 2015. https://repositorio.ufsc.br/bitstream/handle/123456789/134575/baladeborra cha.comautor.pdf?sequence=1.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia em pesquisa científica. UFSM.

Rodriguez, A., Pena, S., Cavieres, I., et al. (2020) Ocular trauma by kinetic impact projectiles during civil unrest in Chile. Eye (Basingstoke). <http://dx.doi.org/10.1038/s41433-020-01146-w

Strong, E. B. (2014). Orbital fractures: Pathophysiology and implant materials for orbital reconstruction. Facial Plastic Surgery. 30(5):509–517.

Voiglio, E. J., Frattini, B. & Dorrzapf, J. J. et al. (2004). Ballistic Study of the SAPL GC27 Gun: Is It Really“Nonlethal”? World J Surg. 28(4):402–405.



How to Cite

OLIVEIRA, M. M. M. .; BORGES, A. B. .; ACIOLY , R. da F. .; SOUZA , D. D. de .; CARVALHO, D. do C. .; SILVA , B. A. da . Orbitary fracture caused by rubber project: Case report. Research, Society and Development, [S. l.], v. 10, n. 6, p. e44710615976, 2021. DOI: 10.33448/rsd-v10i6.15976. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/15976. Acesso em: 23 jun. 2021.



Health Sciences