Gunshot injuries to the extremities: experience of a U.K. trauma centre

Injury. 2005 Mar;36(3):407-11. doi: 10.1016/j.injury.2004.08.003.

Abstract

Background: The Metropolitan Police figures suggest an increase in the incidence of injuries related to gun crime. We conducted a retrospective analysis of extremity gunshot injuries over a five-year period. Our aim is to report on our (1) incidence, (2) complications and (3) experience in treating these injuries.

Methods: Over a five-year period (1998-2002), 70 extremity gunshot injuries in 61 patients were identified from a trauma register and case notes reviewed retrospectively. The following were identified and analysed: type of injury (low or high-energy transfer), treatment (early/late), complications, patient demographics and compliance.

Results: There was a four-fold increase in incidence. Our incidence correlated well with The Metropolitan Police figures (r = 0.93). One-third of our injuries were managed non-operatively and on an outpatient basis. Complications were as follows: eight wound infections, one fracture non-union, one compartment syndrome, one vascular injury and five nerve injuries. Compliance was excellent for high-energy transfer injuries.

Conclusion: Extremity gunshot injuries are on an increase in the United Kingdom highlighting the need for trauma surgeons' knowledge of the management of these injuries. Complications can be reduced to a minimum if the basic principles of management are strictly adhered to.

MeSH terms

  • Adolescent
  • Adult
  • Arm Injuries / complications
  • Arm Injuries / epidemiology*
  • Arm Injuries / therapy
  • Child
  • Female
  • Fractures, Bone / complications
  • Fractures, Bone / epidemiology
  • Fractures, Bone / therapy
  • Humans
  • Incidence
  • Leg Injuries / complications
  • Leg Injuries / epidemiology*
  • Leg Injuries / therapy
  • London / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sex Distribution
  • Soft Tissue Injuries / complications
  • Soft Tissue Injuries / epidemiology
  • Soft Tissue Injuries / therapy
  • Treatment Outcome
  • Wounds, Gunshot / complications
  • Wounds, Gunshot / epidemiology*
  • Wounds, Gunshot / therapy