Management of civilian ballistic fractures

Summary Introduction The management of ballistic fractures, which are open fractures, has often been studied in wartime and has benefited from the principles of military surgery with debridement and lavage, and the use of external fixation for bone stabilization. Hypothesis In civilian practice, bon...

Full description

Saved in:
Bibliographic Details
Published in:Orthopaedics & traumatology, surgery & research surgery & research, 2013-12, Vol.99 (8), p.953-958
Main Authors: Seng, V.S, Masquelet, A.C
Format: Article
Language:English
Subjects:
Adult
Antibiotic Prophylaxis
Ballistic fracture
Civilian
Debridement
Female
Femoral Fractures - diagnostic imaging
Femoral Fractures - surgery
Fractures, Comminuted - surgery
Fractures, Open - diagnostic imaging
Fractures, Open - surgery
Gunshot wound
Humans
Infection
Male
Middle Aged
Military Personnel
Orthopedics
Radiography
Surgery
Therapeutic Irrigation
Ulna Fractures - surgery
Wounds, Gunshot - diagnostic imaging
Wounds, Gunshot - surgery
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary Introduction The management of ballistic fractures, which are open fractures, has often been studied in wartime and has benefited from the principles of military surgery with debridement and lavage, and the use of external fixation for bone stabilization. Hypothesis In civilian practice, bone stabilization of these fractures is different and is not performed by external fixation. Patients and methods Fifteen civilian ballistic fractures, Gustilo II or IIIa, two associated with nerve damage and none with vascular damage, were reviewed. After debridement and lavage, ten internal fixations and five conservative treatments were used. Results No superficial or deep surgical site infection was noted. Fourteen of the 15 fractures (93%) healed without reoperation. Eleven of the 15 patients (73%) regained normal function. Discussion Ballistic fractures have a bad reputation due to their many complications, including infections. In civilian practice, the use of internal fixation is not responsible for excessive morbidity, provided debridement and lavage are performed. Civilian ballistic fractures, when they are caused by low-velocity firearms, differ from military ballistic fractures. Although the principle of surgical debridement and lavage remains the same, bone stabilization is different and is similar to conventional open fractures. Level of evidence Level IV (retrospective study).
ISSN:1877-0568
1877-0568
DOI:10.1016/j.otsr.2013.08.005