Abstract: Fracture Patterns Following Gunshot Wounds to the Upper Extremity (Plastic Surgery The Meeting)

Sunday, September 25, 2016: 11:25 AM

Ahmed M.S. Ibrahim, MD, PhD , Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, LA

Milad El Hajj, BS , Louisiana State University School of Medicine, New Orleans, LA

Anthony Saliba, BS , Louisiana State University School of Medicine, New Orleans, LA

Patrick Emelife, MD , Surgery, Louisiana State University Health Sciences Center, New Orleans, LA

Jonathan S Lam, MD , Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, LA

Frank Lau, MD , Plastic Surgery, Louisiana State University Health Sciences Center, New Orleans, LA

Charles Louis Dupin, MD , Plastic Surgery, Louisiana State University Health Science Center, New Orleans, LA

Kelly L. Babineaux, MD , Surgery, Louisiana State University Health Sciences Center, Metairie, LA

Presentation PDF file

Background:

Upper extremity (UE) 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. The aim of this study was to describe fracture patterns in the UE associated with gunshots at a Level 1 Trauma Center.

Method:

Retrospective review of data collected from 2010 to 2014 at a Level 1 Trauma center based on a single Hand Surgeon’s experience was performed. Demographic data and information on fracture patterns were collected and analyzed.

Results:

259 patients were included in this study. A majority were male (90%) and African American (90%). Mean age was 31 years. 66.9% of UE 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 ED.

Conclusion:

Analysis of UE fractures identifies the most common fracture sites and their characteristics. This is the first study to describe fracture patterns in the UE resulting from gunshots within a civilian population. Further comparison of complication rates may permit broader insight into how patients are currently managed.

29401 Fracture Patterns Following Gunshot Wounds to the Upper Extremity