Infection and complications following low-velocity intra-articular gunshot injuries (original) (raw)
Related papers
Injury, 1998
The incidence of intra-articular low-velocity gunshot wounds is increasing as the number of civilians injured by handguns grows. The severity of these injuries can vary and the general principles of managing them, particularly in regards to the role of irrigation, debridement and prophylactic antibiotics, are evolving. The authors suggest that injuries can be classified according to the ultimate location of the projectile, the level of contamination, and the type of fracture present. Injuries in which the projectile has no contact with the synovial fluid, with a low level of contamination, and a stable fracture pattern may be treated non-operatively, with antibiotics only. Wounds in which the bullet remains in contact with synovial fluid have a higher level of contamination or have a fracture requiring internal fixation and intravenous antibiotics in combination with more aggressive surgical treatment.
Infection rates and treatment of low-velocity extremity gunshot injuries
Journal of orthopaedic trauma, 2017
To determine the rates of infection in low-energy gunshot wounds (GSWs) to the extremity. Retrospective review. Level I trauma center. Patients (N=140) with at least 90-day follow-up for extremity-only low-energy GSW injuries from 2010-2014 were retrospectively reviewed. Treatment was recorded, including type and duration of antibiotics and details of non-operative and operative management. s MAIN OUTCOME MEASURES:: The rates of superficial and deep infections. The overall infection rate was 15.7% (22 patients), and the deep infection rate was 3.6% (5 patients). Age, gender, and injury location were similar between the groups that did and did not receive antibiotic prophylaxis. Injury Severity Scores were higher in the group that did receive antibiotics. Regarding soft tissue-only injuries, antibiotic prophylaxis trended toward a lower rate of overall infection versus no antibiotic prophylaxis (6.1% vs. 25.9%, respectively, p=0.07). Multiple doses of antibiotics did not reduce the r...
Management of Gunshot Fractures to the Extremities - A Narrative review
Journal of orthopaedic reports, 2023
Abstract Objectives To review the literature regarding antibiotic protocols, indications for formal irrigation, timing of debridement, and outcomes following fixation for low and high velocity gunshot fractures. The limitations in the literature will also be discussed.
Treatment of purulent-inflammatory complications in a combat gunshot trauma.
Modern Medical Technology, 2019
Autors: Fomin O. O., Kovalchuk V.P., Fomina N.S., Zheliba M.D., Dobrovanov Oleksandr, Karol Kralinsky. Purpose of the study. Justification of the effectiue treatnxent tactics of the wounded with the gunshot fractures of the long bones. Materials and methods. The exarnination and treatment of 123 wounded'with gunshot fractures were perform'ed. All wounded were diuided into 3 groups according to ctinical observation. For the first clinical group the traditional treatment of the combat fractures with osteometallosynthesis out of injury zone was done. In the second group treatment was added with negatiue pressure therapy. In the third clinical group Wounded got a VAC - associated therapy with the proposed of counter-druinage of wounds with the flow-washing inigation with antiseptic solutions Decasan + 3% hgdrogen peroxyde. A bacteriological study of the wounds exudates was carried out, and the sensitivity of microorganisms to antibiotics was determined.
Intraarticular Findings After Gunshot Wounds Through the Knee
Journal of Orthopaedic Trauma, 1997
Objectives: To compare the radiographic findings in patients with a low-velocity gunshot wound through the knee with the intraarticular pathology as documented by arthroscopy, and to evaluate arthroscopic management of these injuries. Study Design: Retrospective review of a protocol. Materials and Methods: Thirty-three patients with low-velocity gunshot wounds through the knee, no significant soft tissue injury, and no fracture requiring repair were studied. Radiographs were evaluated for bullet fragments, loose bodies, and debris. All patients were treated with arthroscopic evaluation and management of intraarticular pathology. The arthroscopic findings were compared with the radiographic findings. Results: Five chondral injuries and fourteen meniscal injuries not suspected on the basis of plain films were found during arthroscopic evaluation. Seven patients had no radiographic evidence of debris, loose bodies, or bullet or bone fragments in the joint. Five of these seven (71%) had debris and meniscal damage. Debridement of all loose bodies was possible using arthroscopy and occasional miniarthrotomy. No patient in the series had an infection. Conclusions: Patients who sustain a low-velocity gunshot through the knee have soft tissue injuries not visible on plain radiographs in most cases, and therefore operative treatment is warranted. Arthroscopic management of these
The Israel Medical Association journal : IMAJ, 2009
Gunshot wounds impose a continuous burden on community and hospital resources. Gunshot injuries to the extremities might involve complex soft tissue, bone, vascular, musculotendinous, and nerve injuries. A precise knowledge of anatomy is needed to evaluate and treat those injuries. To review our experience with gunshot wounds to the extremities. We retrospectively reviewed all civilian cases of gunshot wounds to the limbs treated in our institution during 2003-2005. Altogether, we evaluated 60 patients with 77 injuries. Of the 60 patients 36 had fractures, 75% of them in the lower extremity and 81% in long bones. The most common fixation modality used was external fixation (33%), followed by intramedullary nailing (25%). This relatively high percentage of fracture treated with external fixation may be attributed to the comminuted pattern of the fractures, the general status of the patient, or the local soft tissue problems encountered in gunshot wounds. About one-fifth of the fractu...
Functional Outcomes After Gunshot Wounds to the Foot and Ankle
The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 2015
The peer-reviewed, clinical data focusing on foot and ankle gunshot wounds are limited. The present study aimed to evaluate functional outcomes in a case series according to the area of injury, articular involvement, and the presence of infection. From January 2003 through February 2011 (8 years), 37 patients treated at Sinai-Grace Hospital (Detroit, MI) for civilian gunshot wounds localized to the foot and/or ankle were reviewed. Of these, 27 (72.97%) met the inclusion criteria. All acute wounds were thoroughly irrigated in the emergency room (8 of 27, 29.63%) or operating room (19 of 27, 70.37%) within 1 hour of presentation. The injuries were categorized as either zone 1 or 2, if localized distally or proximally to the midtarsal joint, respectively. The Maryland Foot Score was recorded and compared based on the location, articular involvement, and infection status, using analysis of variance. The mean Maryland Foot Score in patients with zone 1 injuries was 89.3 (range 72 to 100)...
Diagnostics and treatment of low-velocity gunshot wounds in the hip joint region
European Orthopaedics and Traumatology, 2012
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