Gunshot Wounds to the Hand: Management and Economic Impact

Chappell, James E.; Mitra, Amit; Weinberger, Jeremy; Walsh, Laura

doi:10.1097/00000637-199904000-00012

Cited by 28 publications

(14 citation statements)

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“…6 Similar to our findings, the cost of treating hand trauma caused by gunshot wounds is sizeable. In 1999, Chappell et al 7 reported the health care cost analysis of 90 patients treated for gunshot wounds to the hand. The total health care expenditure was greater than $1.7 million (mean cost, approximately $19,000 per case).…”

Section: Discussionmentioning

confidence: 99%

The Economic Impact of Electric Saw Injuries to the Hand

Hoxie

Capo

Dennison

et al. 2009

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

The Economic Impact of Electric Saw Injuries to the Hand

Hoxie

Capo

Dennison

et al. 2009

The Journal of Hand Surgery

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“…13 However, there has been a recent shift toward early definitive fixation, minimizing the usage of antibiotics, and early bone grafting. [1][2][3][4]6,7,9,[12][13][14][15]17,18 Finally, successful recovery from complex ballistic fractures requires an early and regimented therapy program, which is often difficult to obtain in this population.…”

Section: Introductionmentioning

confidence: 99%

Current Trends in the Management of Ballistic Fractures of the Hand and Wrist: Experiences of a High-Volume Level I Trauma Center

Ghareeb

Daly

Liao

et al. 2017

Hand (New York, N,Y.)

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The majority of patients in this report underwent early operative intervention with percutaneous fixation. Antibiotics were administered in almost all cases and can usually be discontinued within 24 hours after surgery. It is important to consider concomitant nerve, vascular, or tendon injuries requiring repair. We recommend early treatment of these injuries with debridement and stabilization. Due to lack of follow-up and patient noncompliance, early definitive treatment with primary bone grafting should be considered.

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“…Low-velocity gunshot wounds frequently cause only moderate damage to the soft tissue envelope, which allows early closure and fracture fixation [2,7]. These fractures are often associated with loss of stability and comminution of more than 50% and tend to redisplace and shorten when treated conservatively [7].…”

Section: Discussionmentioning

confidence: 99%

“…These fractures are often associated with loss of stability and comminution of more than 50% and tend to redisplace and shorten when treated conservatively [7]. Chappell et al advocate early fracture stabilisation and a low threshold for internal fixation for gunshot wounds to the hand, as conservative regimens cause a higher complication rate and higher economic impact [2]. Kiehn, Mitra and Gutowki have reported low infection rates with early definitive treatment for fractures without bone defects [8].…”

Section: Discussionmentioning

confidence: 99%

Handgun injuries with metacarpal and proximal phalangeal fractures: early definitive treatment

Kömürcü

Kürklü

Özkan

et al. 2007

International Orthopaedics (SICO

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Most gunshot injuries to the hand involve a combination of tissue types. The goal of this study is to report the results of early definitive treatment in extra-articular metacarpal and proximal phalangeal fractures due to low velocity gunshot wounds and to analyse their outcomes. A retrospective analysis of 51 metacarpal and 41 proximal phalangeal fractures of 76 patients due to low velocity gunshot wounds treated between January 2001 and December 2004 was carried out. We applied acute fixation in the first 24 hours. The patients were evaluated with total active motion scores, radiographic control, complication rate and the need for revision surgery. The infection frequency was 10.5% and the need for a revision surgery was 7%. The plate fixation group had significantly higher total active motion scores than the external fixation group. The K wire group had the highest revision rate. The bone grafting group was associated with good total active motion scores and low complication rates. The majority of the low velocity gunshot injuries are surgically clean wounds which allow not only early fracture fixation, but also early bone grafting and soft tissue reconstruction. Plate and screw fixation is associated with significantly better functional outcomes than the minimal fixation group.

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Gunshot Wounds to the Hand: Management and Economic Impact

Cited by 28 publications

References 0 publications

The Economic Impact of Electric Saw Injuries to the Hand

The Economic Impact of Electric Saw Injuries to the Hand

Current Trends in the Management of Ballistic Fractures of the Hand and Wrist: Experiences of a High-Volume Level I Trauma Center

Handgun injuries with metacarpal and proximal phalangeal fractures: early definitive treatment

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