9.0: Thursday, March 17, 2005
7737

Treatment of Civilian Gunshot Wounds to the Upper Extremity

Robert Rodrigues, MD, Douglas M. Sammer, MD, and Kevin C. Chung, MD.

Background

Firearm injury is a serious public health concern in the United States. There are approximately 115,000 firearm-related injuries per year in the U.S., making it the highest incidence in the world. The purpose of this paper is to describe the management of upper extremity combined injuries related to firearm injuries at the University of Michigan Medical Center

Methods

We retrospectively reviewed all the upper extremity gunshot wound injuries at the University of Michigan treated by the senior author from 1996 to 2003. Patients were treated based on the principle of early aggressive debridement of the wound, completing reconstruction within one week of injury, followed by immediate hand therapy.

Result

Eighteen combined gunshot wound injuries to the upper extremity were identified. Mean age was 28.5 years, and the average length of stay in the hospital was 7.7 days with a mean follow-up of 319 days. There were no early infections in this series, and all patients regained functional use of their arms.

Conclusion

Gunshot injury is a serious public health problem in the United States and adoption of early aggressive reconstruction can enhance functional outcomes, while decreasing resource utilization from prolonged hospitalization.