Multipiece tire rim injuries. Multipiece tire rims can explode during tire change, causing severe injury. Although more than 450 such accidents, with at least 80 deaths, have been recorded by the National Highway Traffic Safety Administration (NHTSA), we found no reports in the surgical literature on such injuries in the United States. This report describes experience with seven patients who sustained injuries in explosions of multipiece tire rims. All victims suffered massive maxillofacial trauma with associated ocular, cranial, intracranial, and extremity injuries. Two patients died, both because of intracerebral hemorrhage. One patient suffered serious long-term disability. All survivors required extensive reconstructive surgery. The design of the multipiece tire rim is inherently hazardous. Since many accidents of this type are not reported to the NHTSA, the incidence of such injuries may be significantly higher. An alternative, nonhazardous tire rim is available. Design modifications or a law restricting use of multipiece tire rims would prevent many accidents. 