Article

2 Iconography
Access to the text (HTML) Access to the text (HTML)
PDF Access to the PDF text
Advertising


Access to the full text of this article requires a subscription.
  • If you are a subscriber, please sign in 'My Account' at the top right of the screen.

  • If you want to subscribe to this journal, see our rates



@@#116300@@

Orthopaedics & Traumatology: Surgery & Research
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 11 janvier 2019
Doi : 10.1016/j.otsr.2018.11.002
Received : 24 May 2018 ;  accepted : 13 November 2018
Treating fractures in upper limb gunshot injuries: The Cape Town experience
 

Esmee Wilhelmina Maria Engelmann , Stephen Roche, Sithombo Maqungo, DuPreez Naude, Michael Held
 Groote Schuur Hospital, Cape Town, South Africa 

Corresponding author. Groote Schuur Hospital, Orthopaedic Surgery, Old Main Building, Main Rd, Observatory, Cape Town 7925, South Africa.Groote Schuur Hospital, Orthopaedic Surgery, Old Main BuildingMain Rd, ObservatoryCape Town 7925South Africa
Abstract
Background

Upper extremity gunshot fractures are generally treated conservatively or surgically using open reduction and internal fixation (ORIF), intramedullary nails (IM) or external fixators. However, there is no gold standard for the management of these complex, multi-fragmentary upper extremity fractures. The aim was to describe and identify the injury patterns, management, complications and associated risk factors for upper extremity gunshot fractures.

Patient and methods

Data of patients with upper extremity gunshot injuries that presented to a Level I Trauma Unit in Cape Town, South Africa was collected prospectively over a ten-month period from June 2014 to April 2015. Clinical notes and radiographs were reviewed retrospectively.

Results

Fifty-one of 90 patients (56.7%) with ballistic injuries had fractures, 30% had neurovascular injuries and 75% had additional injuries to other anatomical structures including head, neck, spine, chest, abdomen, pelvis and urogenital tract. Most fractures were diaphyseal, multi-fragmentary and extra-articular. Fractures were treated conservatively in more than half of the cases. Median fracture length was 5.5 centimetres. A longer fracture zone was statistically associated with surgical treatment. When surgically treated, open reduction and internal fixation was most often performed. Median hospital stay was six days. Infection and injury severity prolonged hospital stay.

Discussion

In contrast to studies from the USA and Europe, most fractures in this study were managed conservatively. High quality prospective controlled trials are required to evaluate radiographic and clinical outcomes of treatment methods for upper extremity gunshot injuries.

Level of evidence

IV, case series.

The full text of this article is available in PDF format.

Keywords : Orthopaedic trauma, Gunshot, Epidemiology, Upper extremity, Humerus, Radius




© 2018  Elsevier Masson SAS. All Rights Reserved.
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Close
Article Outline