Gunshot-related lower extremity nerve injuries

Baker, Hayden P.; Straszewski, Andrew J.; Dahm, James; Dickherber, Jason L.; Krishnan, Pranav; Dillman, Daryl

doi:10.1007/s00590-022-03220-3

Cited by 7 publications

(7 citation statements)

References 13 publications

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“…Associated injuries after periarticular ballistic injuries follow similar patterns to those of other areas of the body. There exists large variability in the rates of documented neurovascular injury with 2 recent studies at a single high-volume institution with peripheral nerve injuries of 30% in the upper extremity and 14% in the lower extremity 14,15 . Higher rates of nerve injury seem to be particularly more common around the joints 72,73 .…”

Section: Intra-articular Injuries and Arthrotomiesmentioning

confidence: 99%

“…An abnormal ankle-brachial index with a ratio of <0.9 warrants further investigation in the form of computed tomography (CT) angiography 13 . A high index of suspicion for concomitant neurologic injury should be present in those with ballistic long-bone fractures and vascular injuries because the rate of associated neurologic injury is high (18%-71%) 14-16 , as should suspicion for compartment syndrome 17 .…”

Section: Long-bone Injuriesmentioning

confidence: 99%

“…In modern literature, similar rates of infection and nonunion have been reported after low-energy ballistic tibia fractures treated with prophylactic antibiotics and surgical stabilization compared with closed fracture patterns 41 . Concomitant neurologic and vascular injuries are common, with 1 case series demonstrating 14% rate, compared with the general trauma population (1%-3%) 14,60,61 . The common peroneal nerve is most frequently affected 14 .…”

Section: Long-bone Injuriesmentioning

confidence: 99%

“…Concomitant neurologic and vascular injuries are common, with 1 case series demonstrating 14% rate, compared with the general trauma population (1%-3%) 14,60,61 . The common peroneal nerve is most frequently affected 14 . Associated compartment syndrome must also be carefully evaluated for with concomitant neurologic/vascular injury.…”

Section: Long-bone Injuriesmentioning

confidence: 99%

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Firearm-Related Injuries—Wound Management, Stabilization, and Associated Injuries

et al. 2023

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Gun violence–related and firearm-related injuries are a public health crisis with increasing rates, particularly among younger demographics, in the United States despite a decline in incidence worldwide.There exists limited high-quality evidence to guide the management of firearm-related orthopaedic injuries.Associated injuries (i.e., neurological and vascular) are common in ballistic injuries to the extremity.Where indicated, low-energy orthopaedic injuries can be managed successfully with standard fixation and management strategies with similar complications to closed fractures.

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Section: Intra-articular Injuries and Arthrotomiesmentioning

confidence: 99%

Section: Long-bone Injuriesmentioning

confidence: 99%

Section: Long-bone Injuriesmentioning

confidence: 99%

Section: Long-bone Injuriesmentioning

confidence: 99%

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Firearm-Related Injuries—Wound Management, Stabilization, and Associated Injuries

et al. 2023

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“…It is well-established that gun violence has been increasing throughout the country, especially in urban settings 1-3 . Ballistic injuries present unique challenges in management, including unusual fracture patterns, soft-tissue injuries, and reconstructive opportunities 4-6 .…”

mentioning

confidence: 99%

Bullet Fragment Retrieval During Intramedullary Nailing

Serotte,

Cahill,

Strelzow

2023

JBJS Case Connector

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Case: Two young adult patients, 22 and 27 years, who sustained ballistic long bone fractures, presented for incarcerated, retained metallic fragments in the medullary canal, which blocked fixation. Owing to the presence and location of the fragments, each case required a bullectomy (removal of the metallic fragment) before intramedullary nail fixation because the projectile impeded the appropriate insertion of the intramedullary rod and, in one case, induced fracture malalignment. Attempts at removal using conventional tools did not provide adequate length or grasp of the retained projectile, necessitating the use of the novel technique. The Babcock Laparoscopic Endopath is an easy-to-use, ubiquitous tool that facilitates the removal of content within the intramedullary canal, including metallic or bony fragments. Conclusion: There is limited literature describing accessible, cost-effective techniques for the removal of intramedullary retained metallic foreign fragments when it is unremovable through conventional means. This article reports on a novel, minimally invasive technique for bullet removal from the intramedullary canal of the femur and tibia using the Babcock Laparoscopic Endopath, a tool typically used by urologists. Both patients were followed for at least 8 weeks postoperatively with no complications secondary to the procedure. The article describes the technique and advantages of using this readily available tool that is both flexible enough to navigate through the intramedullary canals as well as rigid enough to obtain and manipulate metallic objects.

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