Management of Civilian Low-Velocity Gunshot Injuries to an Extremity

Abstract Case records of 88 patients with low-velocity gunshot injuries of the terminal spinal cord and cauda equina treated by laminectomy at Cook County Hospital between 1969 and 1987 were reviewed. Sixty-one patients were operated upon within 72 hours of injury, 29 of whom (47.5%) experienced neurological improvement or pain relief. Twenty-seven patients were operated upon at a later time for associated injuries, 13 of whom (48.1%) experienced neurological improvement or pain relief. When laminectomy was delayed for more than 2 weeks, either arachnoid adhesions (15%) or occult abscesses (17%) were observed. From this review as well as from the literature, it appears that the timing of laminectomy for gunshot injuries of the thoracolumbar and lumbosacral spine is not essential to neurological recovery. It appears, however, that adequate debridement of these injuries, performed as soon as the patient is stable from any associated injuries, may help to mitigate the late sequelae of arachnoiditis, infection, and pain syndromes in the lower extremities.

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Infection Rates and Treatment of Low-Velocity Extremity Gunshot Injuries

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000000827 ◽

2017 ◽

Vol 31 (6) ◽

pp. 326-329 ◽

Cited By ~ 8

Author(s):

Mai P. Nguyen ◽

Jonathan C. Savakus ◽

Jeffrey A. OʼDonnell ◽

Nicholas F. Prayson ◽

Michael S. Reich ◽

...

Keyword(s):

Infection Rates ◽

Low Velocity ◽

Gunshot Injuries

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Low-velocity Gunshot Injuries to the Femur

Journal of the American Academy of Orthopaedic Surgeons ◽

10.5435/jaaos-d-17-00849 ◽

2019 ◽

Vol 27 (18) ◽

pp. 685-689

Author(s):

Mai P. Nguyen ◽

Nicholas Prayson ◽

Heather A. Vallier

Keyword(s):

Low Velocity ◽

Gunshot Injuries

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37: Low-Velocity Gunshot Injuries to the Temporal Bone

Otolaryngology ◽

10.1016/s0194-5998(96)80899-0 ◽

1996 ◽

Vol 115 (2) ◽

pp. P172-P172

Author(s):

Steven L. Sabin ◽

Dennis Lee ◽

Neil Sperling ◽

Gady Har El

Keyword(s):

Temporal Bone ◽

Low Velocity ◽

Gunshot Injuries

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Gunshot injuries to the head and brain caused by low-velocity handguns and rifles

Forensic Science International ◽

10.1016/j.forsciint.2004.06.023 ◽

2004 ◽

Vol 146 (2-3) ◽

pp. 111-120 ◽

Cited By ~ 2

Author(s):

M. Oehmichen ◽

C. Meissner ◽

H.G. König ◽

H.-B. Gehl

Keyword(s):

Low Velocity ◽

Gunshot Injuries

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Low-Velocity Gunshot Injuries of the Spine With Abdominal Viscus Trauma

Journal of Orthopaedic Trauma ◽

10.1097/00005131-199809000-00016 ◽

1998 ◽

Vol 12 (7) ◽

pp. 514-517 ◽

Cited By ~ 30

Author(s):

Anant Kumar ◽

George W. Wood ◽

A. Paige Whittle

Keyword(s):

Low Velocity ◽

Abdominal Viscus ◽

Gunshot Injuries

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Low velocity gunshot injuries to the temporal bone

The Journal of Laryngology & Otology ◽

10.1017/s0022215100142112 ◽

1998 ◽

Vol 112 (10) ◽

pp. 929-933 ◽

Cited By ~ 2

Author(s):

Steven L. Sabin ◽

Dennis Lee ◽

Gady Har-El

Keyword(s):

Facial Nerve ◽

Temporal Bone ◽

Nerve Injury ◽

Cavity Formation ◽

Low Velocity ◽

Improve Outcome ◽

Facial Nerve Injury ◽

Gunshot Injuries ◽

Aggressive Management ◽

Cranial Neuropathies

AbstractObjectiveTo review the presentation, symptoms and management associated with low velocity gunshot injuries to the temporal bone.MethodsA retrospective analysis of 26 patients treated for low velocity gunshot injuries to the temporal bone.ResultsInitial presentation included otorrhoea (69 per cent), facial nerve injury (27 per cent), hearing loss (65 per cent), intracranial injuries (50 per cent), and cranial neuropathies (58 per cent). Nine patients (35 per cent) underwent angiography, which showed vascular injury in five of them. Four patients died.ConclusionLow velocity gunshot injuries can be devastating and may result in functional sequelae. Low velocity missiles crush and lacerate surrounding structures, while high velocity missiles cause extensive wound cavity formation. Early aggressive management for intracranial, vascular and facial nerve injury can improve outcome.

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