Abstract
Fifteen clinical cases of gunshot fractures were studied. A radiographic classification of the fractures was developed to aid in fracture evaluation. Type I fractures involved a simple transverse or oblique fracture with minimal soft tissue damage. Type II fractures were severely comminuted with no cortical bone defect and minimal soft tissue damage. Type III fractures were “shatter” fractures, characterized by severe comminution, cortical bone defects, and extensive soft tissue damage. Type I and Type II fractures (combined 26.7%) healed in 8 weeks or less. Eleven of the 15 cases evaluated (73.3%) were found to be Type III fractures, requiring more than 14 weeks for complete cortical healing. Osteomyelitis was associated with 3 cases of Type III tibial fractures, 2 of which developed after a second surgical intervention. Management, complications, and prognosis of gunshot fractures are discussed.
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