Treatment of Gunshot-Related Mandibular Fracture with Splint-Guided Reduction: Case Report

Summary Background/Aim: Gunshot injury-related mandibular fractures often have a complex pattern, characterized by comminution, bone loss, and soft-tissue avulsion. The management is difficult and varies between individual cases. Case Report: A 41-year-old male patient presented with marked swelling and ecchymosis in the left mandibular region. Intraorally, he had a deviated open bite on the left side. A unilateral comminuted mandibular fracture was diagnosed by panoramic radiograph and computed tomography. An acrylic dental splint-guided open reduction and internal fixation, including intermaxillary fixation through brackets and intermaxillary elastics, was planned. No complications were observed throughout the healing period, and healing at the fracture site was satisfactory. The occlusion returned to the preinjury position and was stable. Conclusions: This case report shows that successful functional and esthetic results can be achieved with a strict patient-specific treatment protocol for a comminuted mandibular fracture due to gunshot injury.

Removal of a bullet lying between carotid arteries, following a gunshot injury

Gunshot injuries can be very threatening to the patient's life. A bullet in the neck area after a gunshot usually causes tissue damage and bleeding because of the presence of vital structures in this region. We present the case of a young man that arrived emergently to our hospital because of gunshot injury in the right neck area and the right shoulder. He was hemodynamically stable, with no laryngeal edema or hematoma. The cervical radiography showed a foreign body lying on the right side of the spine, in front of the third cervical vertebra. The CT scanning revealed a metallic foreign body, lying between the internal carotid artery and the external carotid artery, without causing bleeding in the surrounding tissues. A bullet was also found in the right shoulder area. A barium esophagography showed no contrast agent escape. An emergency operation was performed, under general anesthesia. The metallic bullet was found under an enlarged submandibular lymph node and was removed. The bullet removal caused vessel intraoperative bleeding, that was repaired satisfactory. No postoperative complications were noticed and patient was discharged home.

A CLINICAL STUDY OF PENETRATING ABDOMINAL TRAUMA WITH SPECIAL REFERENCE TO ITS MANAGEMENT : AN INDIAN SCENARIO

Introduction: The incidence of penetrating abdominal injuries has been on the rise. The common availability of rearms, the lack of proper law, armed conicts, civil violence and road trafc accidents are the major causes of penetrating abdominal injuries. As patient with penetrating abdominal trauma are at risk of harbouring life threatening injuries, early diagnosis and timely intervention is the most important steps to reduce its morbidity as well as mortality. Recently due to improvement of the present healthcare system, the outcome of these injuries is improving. Materials And Methods: A descriptive observational study was carried out on 60 cases of penetrating abdominal injuries. A predesigned pretested schedule was used for data collection. Interview of the study subject and evaluation of all clinical reports was done to obtain the history, clinical ndings, management, complications, mortality and follow up. Before data collection, informed consent was obtained from each and every study subjects. Results: The overall incidence of penetrating abdominal trauma was found to be 2.30% of the total admission of 6217 patients in the department of surgery. The most common cause of penetrating abdominal injury found in this study is stab injury by sharp objects which is followed by gunshot injury. The commonest age group affected was 20 to 30 years which comprises about 41.67%. In this study we found a male preponderance in cases of penetrating injury to the abdomen. In most of the cases the mode is homicidal stab or gunshot injury followed by accidental injuries. Pain, abdominal distension and bleeding from the wound are the main presenting symptom. After initial evaluation with USG (FAST),CTscan abdomen is the most valuable investigation so far. In this series, it is found that the small intestine is the most commonly involved viscera followed by colon, omentum, mesentery and liver respectively. Most common complications after operative intervention was wound infection. The average hospital stay was 6 to 15 days. It has been observed that the post-operative complications, associated injuries and multiple organ injuries are the cause of increased hospital stay. Conclusion: Penetrating trauma can be serious because it can damage internal organs and presents a risk of shock and infection. In the present year, due to overall improvement in the communication and transportation, better monitoring systems and resuscitative measures, improvised diagnostic methods, better availability of blood and blood products, better medications and more skilful surgical techniques, the outcomes of these injuries are improving.

Specifics of fire damage to cotton clothing while shooting point-blank at a human torso simulator from a Fort-12RM pistol

This Article Purpose is to determine specifics of damage to cotton jer-sey, arising from a point-blank shot from a nickel-plated “Fort-12RM” pistol, equipped with .45 Rubber cartridges into dressed simulator of a human torso made of ballistic gel. For achieving this goal, 12 human torso simulators were made, dressed in cotton T-shirts, with the subsequent firing of shots using a nick-el-plated “Fort-12RM” pistol equipped with .45 Rubber cartridges. The shots were fired from a distance, closely followed by examination of damage to cloth-ing using photographic and microscopic research methods. Obtained data and their comparison with the previously obtained research results when the shots were fired at the clothing samples, fixed in the frame made it possible to identify important differences and for the first time describe the phenomenon of internal muzzle imprint mark and volumetric muzzle imprint mark; while describing the internal muzzle imprint mark, specific deposition of additional factors of the shot (namely, soot), reminiscent of a candle flame was found. In addition, a double marker phenomenon was observed around the input gunshot injury on the inves-tigated human torso simulator. Most of additional factors of the shot (in form of soot and dust particles of unburned gunpowder) were determined in wound channel. While carrying out the contact-diffusion method of research, small particles of nickel were determined around input fire damage to the simulator. The revealed differences require revision of the classical method of experimental shooting, while test samples of clothing are fixed in a frame or fixed in a similar way. An important stage in research formulation is to recreate the conditions as close as possible to real ones. The search for the most appropriate, efficient and simple method for carrying out such experiments is promising for ballistics