Comparison of the Damage Results of Bullet and Pellet Ammunition in Firearm Injuries Causing Bone Fractures in the Extremities

Abstract

Objective
 The spectrum of firearm injuries (FI) is broad and challenging for physicians in terms of diagnosis and treatment. The bullets and pellet ammunition used in FI exhibit different ballistic patterns and cause quite different damage to the body. The aim of this study was to compare the outcomes of bullet and pellet injuries causing bone fractures in the extremities.
 Methods
 The files of patients who were injured in their extremities due to civilian FI between 2016 and 2020 and who were followed up by the orthopedic clinic due to bone fractures were retrospectively analyzed. Age, gender, injured extremity, presence of infection, presence of vascular injury, presence of nerve injury, total number of operations, length of hospital stay and permanent sequelae were evaluated. Cases with missing files were excluded from the study. Evaluation criteria were compared under two main headings for bullet and pellet ammunition types.
 Results
 There were a total of 40 cases with a mean age of 43.5 years. The mean follow-up period was 41.5(24-61) months. 39 of the cases were male and 1 was female. There were 28 bullet injuries and 12 pellet injuries. Thirty-two of the cases were lower extremity injuries and 8 were upper extremity injuries. There were significant differences between ammunition type and number of operations (p=0.032).The length of hospital stay was significantly higher in the pellet group (p=0.024, p=0.024. Overall, 12.5% infection, 10% vascular damage, 17.5% nerve damage and 30% permanent sequelae occurred as a result of treatments. There were no significant differences between the groups in terms of infection, vascular injury, nerve injury and permanent sequelae.
 Conclusion
 When comparing the clinical outcomes of bullets and pellet ammunition, there were many differences in the severity of the injury and the treatment process.