Gunshot Injuries of the Hand: Incidence, Treatment Characteristics, and Factors Associated With Healthcare Utilization

Background The objectives of this study are to: (1) describe the demographics, injury patterns, and treatment characteristics of patients who sustained a gunshot injury (GSI) of the hand; and (2) examine the utilization of healthcare resources in patients with a GSI of the hand. Methods We retrospectively identified 148 adult patients who were treated for a GSI of the hand between January 2000 to December 2017 using multiple International Classification of Diseases Ninth and Tenth Edition (ICD-9 and ICD-10) codes. We used bivariate and multivariable analysis to identify which factors are associated with unplanned reoperation, length of hospitalization, and number of operations. Results Multivariable logistic regression showed that fracture severity was associated with unplanned reoperation. Multivariable linear regression showed that fracture severity is associated with a higher number of hand operations after a GSI of the hand, and that a retained bullet (fragment) and patients having gunshot injuries in other regions than the hand had a longer length of hospitalization. Seventy (47%) patients had sensory or motor symptoms in the hand after their GSI, of which 22 (15%) patients had a transection of the nerve. Conclusions Sensory and motor nerve deficits are common after a GSI of the hand. However, only 31% of patients with symptoms had a transection of the nerve. A retained bullet (fragment), having more severe hand fractures, and GSI in other regions than the hand are associated with a higher number of operation and a longer period of hospitalization.

A Tumor-Like Lump in the Palm Caused by an Inconspicuous-for 75 Years-Bullet

Case. An unusual case of a foreign body in the hand is described here. Excision of a tumor-like soft tissue mass revealed a 75-year-old World War II bullet fragment of which patient was unaware. Conclusion. Differential diagnosis of hand lumps and inflammatory reaction must always include retained foreign bodies even after a very long period of posttraumatic quiescence or patient’s inability to provide a relative injury case history.

Possibility of the Use of Different Types of Materials in Passive Ventilation Systems of Munitions

The paper presents different types of insensitive munition used in military equipment, especially in western countries. Tests of this munition, their parameters, e.g. fast and slow heating, bullet, fragment and shaped charge jet impact and sympathetic reaction are described. The characteristics of shape-memory materials like alloys and polymers are presented. Behaviour of shape-memory alloy is explained by example of TiNi al-loys during mechanical or thermal loading, and martensitic transformation into austen-ite during unloading. Material parameters of the TiNi alloys, their testing and mathematical equations are shown. Venting systems used in the explosive reactive armour cassettes are presented. Different examples of materials, including shape-memory materials in munition, are demonstrated.