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Fracture Patterns Following Upper Extremity Gunshot Wounds: A Preliminary Study
Ahmed Ibrahim, MD, PhD, Milad El Hajj, BS, Anthony Saliba, BS, Jonathan Lam, MD, Frank Lau, MD, Oren Tessler, MD; Kelly Babineaux, MD
Louisiana State University, New Orleans, LA

Introduction: Upper extremity fractures following gunshots are a commonly encountered scenario for surgeons in the emergency room. Despite this, there is sparse data published on fracture patterns associated with this mechanism of injury within a civilian population. The aim of this study was to describe fracture patterns in the upper extremity associated with gunshots at a Level 1 Trauma Center.
Materials & Methods: A retrospective review of data collected from 2010 to 2014 at a Level 1 Trauma center based on a single Hand Surgeonís experience was performed. Demographic data and information on fracture patterns were collected and analyzed.
Results: Two hundred fifty-nine patients were included in this study. A majority were male (90%) and African American (90%). Mean age was 31 years. 66.9% of upper extremity gunshot wounds affected the hand. The most prevalent forearm fractures involved the distal radius (39.65%) of which 18.97% were associated with concurrent hand injury. The most prevalent hand fractures were those of the metacarpal (25%) and phalangeal (22.8%) bones. Deeper structures of the hand and wrist were affected in only 13.4% and 6.8% of patients with minor hand and wrist lacerations, respectively. 39.1% of patients underwent operative intervention, 19.7% were admitted to the ICU for management of other injuries and 4.8% expired in the emergency room.
Conclusion: Analysis of upper extremity fractures identifies the most common fracture sites and their characteristics. This is the first study to describe fracture patterns in the upper extremity resulting from gunshots within a civilian population. Further comparison of complication rates may permit broader insight into how patients are currently managed.


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