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This prospective study evaluated the efficacy of an outpatient management protocol for patients with a gunshot-induced fracture with a stable, nonoperative configuration. Forty-one patients (44 fractures) with a grade I or II open, nonoperative fracture secondary to a lowvelocity missile comprised the study population. Patients were treated by a standard protocol, which included 1 g of cefazolin administered in the emergency room and a 7-day course of oral cephalexin. Follow-up visits were performed until complete wound and fracture heaiing were achieved. Thirty-two (78%) of 41 patients underwent full followup. Average follow-up was 5.2 months. One (2.8%) fracture (distal fibula) developed a superficial infection, which responded to an additional week of oral antibiotics, and no patient developed a deep infection. There was 1 delayed union and 2 patients with painful retained shrapnel. These results demonstrate that patients with stable, low-velocity, gunshot-induced fractures can be managed effectively and safely on an outpatient basis using this protocol.

Our broad, multinational/multi-airframe analysis reveals that the pilot profession, most notably high performance and long-haul cargo/passenger airframes, display an increased risk of neck pain symptoms.

Most patients in the military setting had a positive view of the relationship that their surgeons had with industry, which is reflective of data obtained in the civilian literature.

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