These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Treating fractures in upper limb gunshot injuries: The Cape Town experience.
    Author: Engelmann EWM, Roche S, Maqungo S, Naude D, Held M.
    Journal: Orthop Traumatol Surg Res; 2019 May; 105(3):517-522. PubMed ID: 30639031.
    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.
    [Abstract] [Full Text] [Related] [New Search]