Factors Affecting Physical and Psychiatric Morbidity in Civilian Extremity Injuries of Firearms

Abstract

Introduction and aim: Shoutgun injuries are one of the most important social and medical problems of our country. Shotguns produce a wide variety of injuries, ranging from minor pellet wounds to major blast injuries and the extremities are the most commonly injured areas. Although ballistic and clinical differences exist, shotgun injuries are generally classified together with pistol injuries. The aim of this study was to investigate the prevalence of musculoskeletal and neurovascular system injuries and to determine the the effects of physical and psychiatric morbidity in pistol bullet and shotgun pellet injuries. Patients and method: The records of 46 patients treated between January 2009-January 2011 with firearm injuries and who were followed for one year were reviewed. Injuries were classified according to the classification of Sherman. Trauma severity was evaluated with the severity of the injury score (ISS). Anxiety and depression scores were evaluated with Hospital Anxiety and Depression (HAD) scale. All patients were evaluated with Daily Living Activities (ADL) score in terms of quality of life and activities. Results: 27 of 46 patients had shotgun injuries and 19 of 46 had revolver injuries. The mean age was 34.70 ± 14.71, males (82.6%) were commonly injured and lower limb injuries (52.2%) were the most common injuries. Patients (58.7%) were commonly injured wih shotgun and type 3 was the most common injury type (22/46). ISS, HAD and ADL scores were not found significantly different between shotgun and pistol groups in terms of age, gender, type of injury, morbidity, mortality, complications, duration of hospitalization and bone fractures, (p> 0.05). However, there were not any significant difference in HAD scores according to the type of injury; ISS (p = 0.016) and ADL (p = 0.025) scores were significantly different between injury types. Discussion: This study revealed no significant difference between the effects of different weapons on injury severity. Functional outcomes were worse for type 3 shotgun injuries. As a result, we would like to emphasize that the type of injury was found more important than the gun type, gunshot injuries may result in physical disability and psychological morbidity.