Gunshot fractures: a medical, social, and economic analysis.
One hundred ten fractures due to gunshots were reviewed to examine the medical, social, and financial implants of such injuries. The population was predominantly male (91%), unemployed (56%), and uninsured (79%). Sixty-eight percent were documented substance abusers, and 65% of the injuries appeared to be related to illicit drug activities. There were 94 long bone fractures and 16 intraarticular fractures. Early operative treatment was employed in 64 patients (58%) with formal internal fixation in 31. There was no difference between type of treatment, associated injury variables, and outcome, and no increase in complications with acute operative management employing internal fixation. Medical charges averaged $13,108 per patient, a 1200% increase over injuries treated at this institution in 1972 and a rise far in excess of the medical care inflation rate (334%) during the same period.
Hakanson
R
R
Department of Orthopedic Surgery, Carolinas Medical Center, Charlotte, NC 28232.
Nussman
D
D
Gorman
R A
RA
Kellam
J F
JF
Hanley
E N
EN
D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D005249:Fees and Charges; D005260:Female; D005592:Fracture Fixation / Q000191:economics / Q000379:methods; D050723:Fractures, Bone / Q000145:classification / Q000191:economics / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000150:complications*