Abstract
Twenty-seven fractures in 22 children (14 female, 8 male; average age: 10.5) who suffered
gunshot wounds were retrospectively evaluated. Fourteen of the fractures were caused
by high-velocity weapons, four by low-velocity weapons, and nine by shotguns. One
of the fractures was undisplaced, two were displaced, 10 were comminuted, seven were
comminuted and displaced, and seven had bony defects. Accompanying pathologies included
four physeal, three articular, four visceral, four arterial, six peripheral nerve,
and one spinal cord injury. Initial treatment involved external fixation in 15 patients
and internal fixation in one patient for bone stabilization, while the remaining patients
were treated conservatively.
Late-stage surgery was necessary to achieve soft-tissue coverage in three patients
and to achieve union in six patients. Major complications included amputation in one
patient, non-union in two, delayed union in one, osteomyelitis in one, paraplegia
in one, and loss of peripheral nerve functions in three.
The treatment of fractures associated with firearm injuries in children is never simple.
Fracture defects, accompanying peripheral nerve damage and involvement of the joint
negatively is affect the outcome, increasing the chance that late-stage surgery will
be necessary. Internal bone transport appears to be an efficacious technique in the
treatment of bone and soft-tissue defects associated with firearm injuries in children.
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Article info
Publication history
Accepted:
May 20,
2002
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
