One hundred thirty-two gunshot fractures of the extremities in 126 patients were studied retrospectively and followed until clinical union from January 1980 to January 1985. Civilian handgun missile velocities have increased; should the trend continue, treatment protocols will need to be modified. All uncomplicated low-velocity gunshot fractures, less than 615 m/second, (2000 feet/second), can be managed conservatively, with superficial debridement, surgical cleansing, immobilization, and antibiotics. Seventeen orthopedic procedures were performed; specific treatment was dictated by the type or location of the fracture caused by the missile. One hundred thirty-two fractures were treated with antibiotic therapy, 80 intravenously and 52 oral administration. Only two infections were encountered, both in the oral therapy group. No statistically significant advantage of intravenous over oral administration was found. Emergency room debridement along with oral antibiotic therapy for uncomplicated low-velocity gunshot fractures not requiring operative fixation yielded results comparable to those of hospitalization, with dramatically reduced medical costs.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Infection Rate and Antibiotic Administration for Urban Low-Energy Gunshot Wounds at an Academic Level 1 Trauma Center.
J Am Acad Orthop Surg
January 2025
From the The University of Chicago Department of Orthopaedic Surgery, Chicago, IL.
Introduction: The purpose of this study was to review rates of infection after civilian ballistic fractures and assess the effect of early antibiotic administration (EAA) on infection rates.
Methods: This was a retrospective cohort study done at an urban Level 1 Trauma Center. Patients ages 16 years and older with ballistic orthopaedic extremity injuries between May 2018 and December 2020 were enrolled.
Ballistic femoral neck fractures: Associated injuries and outcomes.
Injury
January 2025
Department of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States. Electronic address:
Background: Ballistic fractures of the femoral neck, rare injuries that overwhelmingly affect younger adults, pose significant challenges to the treating surgeon. However, there is limited literature that the treating surgeon can leverage to guide their treatment decisions. The goal of this study is to describe the demographics, associated injuries, outcomes, and complications associated with ballistic femoral neck fractures.
View Article and Find Full Text PDFMasquelet Technique in the Management of Segmental Bone Defect of the Ulna: A Case Report.
Cureus
December 2024
Department of Family Medicine, Broward Health Medical Center, Fort Lauderdale, USA.
Surgeons periodically encounter challenging clinical scenarios that require them to develop nuanced management strategies to achieve the best outcome for the patient. This is especially true in medically underserved patient populations, where follow-up and proper recovery protocols are often not accomplished. In this report, we discuss the case of a 26-year-old female with a history of medical non-compliance who presented to the emergency department with signs and symptoms of surgical site infection two months following the repair of her comminuted ulna fracture caused by a gunshot wound.
View Article and Find Full Text PDFThe Incidence and Aetiology of Maxillofacial Trauma and Concomitant Traumatic Brain Injury in a Johannesburg Tertiary Hospital.
J Craniofac Surg
January 2025
Department of Oral and Maxillofacial Surgery, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Objective: To investigate the incidence and etiology of maxillofacial trauma (MFT) and its association with traumatic brain injury (TBI).
Background: Anecdotal evidence suggests that there is an association between MFT and TBI and that higher incidences of TBI are associated with frontal bone and mid-facial fractures. Despite the large volume of maxillofacial facial fractures treated in the authors' unit, no study has been undertaken to establish the relationship between TBI and maxillofacial fractures.
Gun-related violence is becoming increasingly more common in the United States, and ballistic injuries pose a challenge to the orthopaedic surgeon on trauma call. The guiding principles of trauma care are almost exclusively based on blunt trauma, and the management principles do not always translate. Ballistic long bone fractures, particularly of the lower extremity, can often be managed with similar principles, although the injury pattern can make restoration of anatomic alignment a challenge.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!