Você está na página 1de 2

Gunshot Wound

What It Is

• Penetrating ballistic injuries that can cause fractures or soft-tissue damage (Fig. 1)

Why It’s an Emergency

• The bullet/shot injury can cause damage to neurovascular structures or cause


unstable fractures.

How “Emergent” Is It?

• Mixed. The urgency of treatment is a function of the underlying soft-tissue/bony


injury, rather than the presence of a gunshot wound itself.

When to Be Suspicious

• Based on both history and physical exam. Gunshot wounds are usually clinically
apparent, provided that a thorough secondary survey has been performed and all
skin exposed.

© Springer International Publishing Switzerland 2017 33


M.C. Makhni et al. (eds.), Orthopedic Emergencies,
DOI 10.1007/978-3-319-31524-9_11
34 J. Shillingford

Fig. 1 Radiograph (a) and CT scan (b) of a gunshot wound involving the femoral neck

How to Diagnose

• Clinically diagnosed by thorough secondary survey.

How to Treat

• Low-velocity wounds are treated as if they were closed fractures despite the skin
injuries:
° Tetanus, oral antibiotics, local wound care
• High-velocity wounds may require I+D if soft-tissue envelope is severely
damaged/compromised.

References

Bartlett CS, Helfet DL, Hausman MR, Strauss E. Ballistics and gunshot wounds: effects on mus-
culoskeletal tissues. J Am Acad Orthop Surg. 2000;8(1):21–36.
Geissler WB, Teasedall RD, Tomasin JD, Hughes JL. Management of low velocity gunshot-
induced fractures. J Orthop Trauma. 1990;4:39–41.

Você também pode gostar