Advertisement
Research Article| Volume 28, SUPPLEMENT 3, C18-C22, 1997

Gunshot wounds of the forearm

  • Christian Foglar
    Affiliations
    University of California, San Francisco, Department of Orthopaedic Surgery, San Francisco General Hospital, 1001 Potrero Avenue, 3A36, San Francisco, CA 94110, USA
    Search for articles by this author
  • Michael Ibarra
    Affiliations
    University of California, San Francisco, Department of Orthopaedic Surgery, San Francisco General Hospital, 1001 Potrero Avenue, 3A36, San Francisco, CA 94110, USA
    Search for articles by this author
  • Theodore Miclau
    Correspondence
    Address for correspondence: Theodore Miclau, M.D., University of California, San Francisco, Department of Orthopaedic Surgery, San Francisco General Hospital, 1001 Potrero Avenue, 3A36 San Francisco, CA 94110, Phone number: (415) 206-8812, Fax number: (415) 647-3733
    Affiliations
    University of California, San Francisco, Department of Orthopaedic Surgery, San Francisco General Hospital, 1001 Potrero Avenue, 3A36, San Francisco, CA 94110, USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The management of gunshot wounds of the forearm has been well documented in the literature. Penetrating projectile injuries of the forearm present treatment problems which are not commonly encountered with blunt injuries, such as neurovascular injury and compartment syndrome. While the management of these injuries is similar to other gunshot wounds of the limbs, the proximity and arrangement of the anatomical structures of the forearm lead to injuries and, therefore, treatment considerations which are unique. The following is a review of the treatment of gunshot wounds of the forearm.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Weaver L.D.
        • Hansraj K.K.
        • Idusuyi O.B.
        • et al.
        Gunshot wound injuries.
        Orthop. Clinics NA. 1995; 26: 1-7
        • Orcutt M.B.
        • Levine B.A.
        • Gaskill H.B.
        Civilian vascular trauma to the upper extremity.
        J. Trauma. 1986; 26: 63-67
        • Spencer A.D.
        The reliability of signs of peripheral vascular injury.
        Surg. Gynecol. Obstet. 1962; 114: 490-494
        • Borman K.R.
        • Snyder W.H.
        • Weigelt J.A.
        Civilian arterial trauma of the upper extremity.
        Am. J. Surg. 1984; 148: 796-799
        • Hammond D.C.
        • Gould J.S.
        • Hanel D.P.
        Management of acute and chronic vascular injuries to the arm and forearm.
        Hand Clinic. 1992; 8: 453-463
        • Gelberman R.H.
        • Nunley J.A.
        • Koman L.A.
        The results of radial and ulnar arterial repair in the forearm.
        J. Bone Joint Surg. 1982; 64-A: 383-387
        • Henderson V.
        • Nambisan R.
        • Smith M.E.
        Angiographic yield in penetrating extremity trauma.
        Western J. Med. 1991; 155: 253-255
        • Moed B.R.
        • Fakhouri A.J.
        Compartment syndrome after lowvelocity gunshot wounds to the forearm.
        J. Orthop. Trauma. 1991; 5: 134-137
        • Elstrom J.A.
        • Pankovich A.M.
        • Egwele R.
        Extra-articular lowvelocity gunshot fractures of the radius and ulna.
        J. Bone Joint Surg. 1978; 60-A: 335-341
        • Hahn M.
        • Strauss E.
        • Yang E.C.
        Gunshot wounds to the forearm.
        Orthop. Clinics NA. 1995; 26: 85-93
        • Ordog G.J.
        • Sheppard G.F.
        • Wasserberger J.S.
        • Balasubramanium S.
        • Shoemaker W.C.
        Infection in minor gunshot wounds.
        J. Trauma. 1993; 34: 358-365
        • Anderson L.D.
        • Sisk T.D.
        • Tooms R.E.
        • Park W.I.
        Compressionplate fixation in acute diaphyseal fractures of the radius and ulna.
        J. Bone Joint Surg. 1975; 57-A: 287-296
        • Fackler M.L.
        • Burkhalter W.E.
        Hand and forearm injuries from penetrating projectiles.
        J. Hand Surg. 1992; 17A: 971-975
        • Paradies L.H.
        • Gregory C.F.
        The early treatment of closerange shotgun wounds to the extremities.
        J. Bone Joint Surg. 1966; 48-A: 425-435
        • Woloszyn J.T.
        • Uitvlugt G.M.
        • Castle M.E.
        Management of civilian gunshot fractures of the extremities.
        Clin. Orthop. 1988; 226: 247-251
        • Hansraj K.K.
        • Wever L.D.
        • Todd A.O.
        • et al.
        Efficacy of ceftriaxone versus cefazolin in the prophylactic management of extra-articular cortical violation of bone due to low-velocity gunshot wounds.
        Orthop. Clinics NA. 1995; 26: 9-17
        • Patzakis M.J.
        • Harvey P.
        • Ivler D.
        The role of antibiotics in the management of open fractures.
        J. Bone Joint Surg. 1974; 56-A: 532-541
        • Tikka S.
        The contamination of missile wounds with special reference to early antimicrobial therapy.
        Acta Chir. Scand. 1982; : 281-287
        • Gustillo R.B.
        • Anderson J.T.
        Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones.
        J. Bone Joint Surg. 1976; 58-A: 453-458
        • Lenihan M.R.
        • Brien W.W.
        • Gellman H.
        • Itamura J.
        • Kuschner S.H.
        Fractures of the forearm resulting from low-velocity gunshot wounds.
        J. Orthop. Trauma. 1992; 6: 32-35
        • Wu C.D.
        Low-velocity gunshot fractures of the radius and ulna: Case report and review of the literature.
        J. Trauma. 1995; 39: 1003-1005
        • Knapp T.P.
        • Patzakis M.J.
        • Lee J.S.
        • Lee P.R.
        • Abdollahi K.
        • Reisch R.B.
        Comparison of intravenous and oral antibiotic therapy in the treatment of fractures caused by low-velocity gunshots.
        J. Bone Joint Surg. 1996; 78-A: 1167-1171
        • Grace T.G.
        • Eversmann W.W.
        Forearm fractures.
        J. Bone Joint Surg. 1980; 62-A: 433-437
        • Chapman M.W.
        • Gordon J.E.
        • Zissimos A.G.
        Compressionplate fixation of acute fractures of the diaphyses of the radius and ulna.
        J. Bone Joint Surg. 1989; 71-A: 159-169
        • Moed B.R.
        • Kellam J.F.
        • Foster R.J.
        • Tile M.
        • Hansen S.T.
        Immediate internal fixation of open fractures of the diaphysis of the forearm.
        J. Bone Joint Surg. 1986; 68-A: 1008-1017
        • Duncan R.
        • Geissler W.
        • Freeland A.E.
        • Savoie F.H.
        Immediate internal fixation of open fractures of the diaphysis of the forearm.
        J. Orthop. Trauma. 1992; 6: 25-31
        • Jones J.A.
        Immediate internal fixation of high energy open forearm fractures.
        J. Orthop. Trauma. 1991; 5: 272-279
        • Levin L.S.
        • Goldner R.D.
        • Urbaniak J.R.
        Management of severe musculoskeletal injuries of the upper extremities.
        J. Orthop. Trauma. 1978; 18: 487-492
        • Smith D.K.
        • Cooney W.E.
        External fixation of high-energy upper extremity injuries.
        J. Orthop. Trauma. 1990; 4: 7-18
        • Wild J.J.
        • Hansen G.W.
        • Bennett J.B.
        External fixation. Use in the management of massive upper extremity trauma.
        Clin. Orthop. 1982; 164: 172-176
        • Luce E.A.
        • Griffen W.O.
        Shotgun injuries of the upper extremities.
        J. Trauma. 1978; : 18
        • Roberts R.M.
        • String S.T.
        Arterial injuries in extremity shotgunwounds: Requisite factors for successful management.
        Surgery. 1984; 96: 902-907
        • Lee R.E.
        • Obeid F.N.
        • Horst H.M.
        Acute Penetrating arterial injuries of the forearm: Ligation or repair?.
        American Surgeon. 1985; 51: 318-324
        • O'Shaughnessy M.
        • O'Riordain D.S.
        • McCann J.
        Consequences of radial and ulnar artery ligation following trauma.
        Br. J. Surg. 1991; 78: 735
        • Russotti G.M.
        • Sim F.H.
        Missile wounds of the extremities: a current concepts review.
        Orthopedics. 1985; 8: 1106-1116