Extremity Gunshot Research Articles

Extremity Gunshot Wounds in Children

A retrospective review of 85 children with extremity gunshot wounds at an average age of 12.3 years showed that 83% were male; there were 10 gunshot and 75 non-shotgun injuries. Thirty-eight children sustained 51 fractures. Seventy-six operations were performed. The average hospital stay was 7.3 days. There were no mortalities, secondary amputations, or progressive neurovascular deficits. There were two wound infections but no cases of chronic osteomyelitis.

Wound Ballistics-Reply

<h3>In Reply.—</h3> Dr Adams' calculations do not support his contention that by "size" Amato et al meant area instead of diameter. The area of the 70.4-mm diameter cavity (11 sphere diameters of 6.4 mm each) is 3892 mm², not 972 mm². Rather than 30-fold, this is a 122-fold difference. If they did mean area, Amato et al erred even more in interpreting their data than I stated. Clearly, the majority of uncomplicated extremity gunshot wounds can be safely managed by simple means. The article by Marcus et al was cited because it implies that only low-velocity gunshot wounds can be handled this way. The initial information given about a shooting (weapon, bullet, and range) is notoriously inaccurate on the urban battle-field of our larger cities. Drs Marcus and Blair's thesis that "an analysis of the history of the injury [is] mandatory to arrive at the appropriate treatment" would