Forensic Ballistics ; Humans ; Maxillofacial Injuries ; surgery ; Wounds, Gunshot ; surgery

Humans ; Maxillofacial Injuries ; diagnosis ; surgery ; Wounds, Gunshot ; diagnosis ; surgery

The Chinese investigators separated bullet wounds into three zones in the beginning of 1980s: a primary wound tract, a contusion zone adjacent to prinary wound tract, and a concussion zone neighboring the contusion zone. Basing on the research results by MRI scan and pathological observation, the author and his coworkers recently proposed that the gunshot wounds should be divided into four consecutive zones: a primary wound tract, a zone of coagulative necrosis, a zone of muscle disruption, and a zone of muscle distortion. A zone of coagulative necrosis plus a zone of muscle disruption equals to a contusion zone, they are separately named because the former is irreversibly devitalized and the latter still has the ability to recover. The sectionalized method shows the range of debridement and provide reference for the conservative treatment or thoroughly debridement. However, the mechanism of each zone need to be further studied.
Debridement ; Humans ; Necrosis ; Wounds, Gunshot ; pathology ; surgery ; therapy

Developing Countries ; Humans ; Spinal Cord Injuries ; Spine ; Wounds, Gunshot/surgery*

An unusual case of a suicidal firearm injury is presented, in which the victim placed the gun under his chin and fired. However, none of the vital structures of the head and face were injured because the victim's chin was considerably anterior to other facial structures as a result of a class III facial deformity. This resulted in the trajectory of the bullet being anterior to vital facial structures and not causing injury to those structures.
Facial Injuries ; surgery ; Humans ; Male ; Prognathism ; Suicide, Attempted ; Wounds, Gunshot ; surgery ; Young Adult

OBJECTIVETo explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result.

METHODSDefects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps.

RESULTSWounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control.

CONCLUSIONSSkin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate.

Animals ; Debridement ; Dogs ; Hindlimb ; injuries ; Microsurgery ; Soft Tissue Injuries ; surgery ; Wound Healing ; Wounds, Gunshot ; surgery

Gunshot injuries are getting more frequently reported while the civilian (nongovernmental) armament increases in the world. A 42-year-old male patient presented to emergency room of Istanbul Medipol University Hospital due to a low-velocity gunshot injury. We detected one entry point on the posterior aspect of the thigh, just superior to the popliteal groove. No exit wound was detected on his physical examination. There was swelling around the knee and range of motion was limited due to pain and swelling. Neurological and vascular examinations were intact. Following the initial assessment, the vascular examination was confirmed by doppler ultrasonography of the related extremity. There were no signs of compartment syndrome in the preoperative physical examination. A bullet was detected in the knee joint on the initial X-rays. Immediately after releasing the tourniquet, swelling of the anterolateral compartment of the leg and pulse deficiency was detected on foot in the dorsalis pedis artery. Although the arthroscopic removal of intra-articular bullets following gunshot injuries seems to have low morbidity rates, it should always be considered that the articular capsule may have been ruptured and the fluids used during the operation may leak into surrounding tissues and result in compartment syndrome.
Adult ; Arthroscopy/*adverse effects ; *Compartment Syndromes ; Humans ; Knee Injuries/*surgery ; Male ; *Postoperative Complications ; Turkey ; *Wounds, Gunshot

In patients presenting with gunshot wounds, a high clinical suspicion of injury to vasculature and viscera remote from the projectile track is paramount. We present a case of a 17 year old male who sustained a gunshot wound to his abdomen and subsequently developed a right external iliac artery contusion requiring surgery as an indirect effect of the pressure wave from the bullet.
Adolescent ; Humans ; Iliac Artery ; injuries ; Male ; Pressure ; Wounds, Gunshot ; complications ; surgery

PURPOSERubber bullets are considered a non-lethal method of crowd control and are being used over the world. However the literature regarding the pattern and management of these injuries is scarce for the forensic pathologist as well as for the traumatologist. The objective of this report was to add our experience to the existing literature.

METHODSFrom June 2008 to August 2010 the Government Hospital for Bone and Joint Surgery Barzulla and the Department of Orthopaedics, SKIMS Medical College/Hospital Bemina Srinagar received 28 patients for management of their orthopaedic injuries caused by rubber bullets. We documented all injuries and also recorded the management issues and complications that we encountered.

RESULTSAll patients weremales with an age range of 11e32 years and were civilians who had been hit by rubber bullets fired by the police and the paramilitary forces. Among them, 19 patients had injuries of the lower limbs and 9 patients had injuries of the upper limbs. All patients were received within 6 h of being shot.

CONCLUSIONOur findings suggest that these weapons are capable of causing significant injuries including fractures and it is important for the surgeon to be well versed with the management of such injuries especially in areas of unrest. The report is also supportive of the opinion that these weapons are lethal and should hence be reclassified.

Adolescent ; Adult ; Child ; Humans ; Lower Extremity ; injuries ; Male ; Rubber ; Wounds, Gunshot ; surgery

OBJECTIVETo explore the clinical characteristics and the effect of surgical therapy for shotgun injuries of the sciatic nerve.

METHODSFrom 1996 to 2000, 19 sciatic nerve injuries resulted from shotgun were observed. Among 19 cases of shotgun sciatic nerve wounds, the gluteal wound was in 2 cases, thigh wound in 15 cases, and knee wound in 2 cases. The firing distance was between 0.5-9 m. According to Shermen classification of shotgun injury, 4 cases belonged to type I injury, 11 cases type II, 4 cases type III. The time from injury to admission was between 2 months-14 months except 1 patient who underwent emergency operation 4 hours after injury, and 1 patient was treated with debridement and epineurial neurorrhaphy, 7 cases with nerve trunk grafting, 6 cases with nerve cable grafting, 4 cases with neurolysis, 1 case with arthrodesis of ankle.

RESULTSNineteen cases were followed-up for 0.8-3.5 years (mean, 19 months). The excellent and good nerve functional recovery was found in 52.6% according to MCRR.

CONCLUSIONSShotgun injuries of the sciatic nerve are very severe and complicated, and injuries in most patients were usually complicated by open fracture, vascular injury, soft-tissue loss and infection; the character of nerve injury was classified as 4-5 degree according to Sunderland Standard, nerve transfer is effective in the treatment of shotgun injuries of the sciatic nerve, but outcome is poor; the recovery of the sciatic nerve should be observed continually after injury; selecting correct initial treatment after injury, strict minimally invasive surgical procedure, physical therapy and reasonable preoperative and postoperative medication can improve the surgical results.

Adolescent ; Adult ; Follow-Up Studies ; Humans ; Male ; Patient Satisfaction ; Sciatic Nerve ; injuries ; surgery ; Treatment Outcome ; Wounds, Gunshot ; complications ; rehabilitation ; surgery