title: Management of low velocity gunshot-induced fractures.
abstract: Bullets fired from civilian weapons are usually of low velocity, resulting in minimal tissue cavitation as compared to high-velocity weapons. A prospective protocol was initiated for patients sustaining a low-velocity gunshot to the extremity resulting in a stable, nonoperative fracture configuration. Treatment consisted of local irrigation and débridement, tetanus prophylaxis as required, a long acting cephalosporin intramuscularly, and splinting or casting of the fractured extremity. Twenty-five patients were managed by this protocol. This patient population was compared to a random retrospective sample of 25 patients with similar ballistic induced fractures and wounds managed by local débridement and 48 h of intravenous antibiotics. One infection occurred in each group, requiring further therapy. We conclude that the patient with a low-velocity gunshot induced fracture can be managed without the use of short-term intravenous antibiotics with no increased risk of infection.
authors.affiliation: Department of Orthopaedics University of Mississippi Medical Center, Jackson 39216.
authors.forename: W B
authors.initials: WB
authors.lastname: Geissler
authors.forename: R D
authors.initials: RD
authors.lastname: Teasedall
authors.forename: J D
authors.initials: JD
authors.lastname: Tomasin
authors.forename: J L
authors.initials: JL
authors.lastname: Hughes
mesh_terms: D000293:Adolescent; D000328:Adult; D015790:Cefonicid / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013165:Splints; D013745:Tetanus Toxoid / Q000627:therapeutic use; D007507:Therapeutic Irrigation; D014946:Wound Infection / Q000517:prevention & control; D014948:Wounds, Gunshot / Q000150:complications*
chemical_list: D013745:Tetanus Toxoid; D015790:Cefonicid