Treatment of close-range, low-velocity gunshot fractures of tibia and femur diaphysis with consecutive compression-distraction technique: a report of 11 cases.
Lower extremity injuries secondary to close-range, low-velocity gunshot wounds are frequently seen in both civilian and military populations. A close-range, low-velocity injury produces high energy and often results in comminuted and complicated fractures with significant morbidity. In this study, four femoral, four tibial, and three combined tibia and fibular comminuted diaphyseal fractures secondary to close-range, low-velocity gunshot wounds in 11 military personnel were treated with debridement followed by compression-distraction lengthening using a circular external fixator frame. Fracture union was obtained in all without significant major complications. Fracture consolidation occurred at a mean of 3.5 months. At follow-up of 46.8 months, there were no delayed unions, nonunions, or malunions. Minor complications included four pin-tract infections and knee flexion limitation in two femur fractures. Osteomyelitis and deep soft tissue infection were not observed. This technique provided an alternative to casting, open reduction internal fixation, or intermedullary fixation with an acceptable complication rate.
Department of Orthopedics and Traumatology, Gülhane Military Medical Academy, Ankara, Turkey. asatesalp@yahoo.com
A Sabri
AS
Ateşalp
Mahmut
M
Kömürcü
Bahtiyar
B
Demiralp
Dogan
D
Bek
Erbil
E
Oğuz
Ibrahim
I
Yanmiş
D000328:Adult; D001858:Bone Nails; D003646:Debridement; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D044709:Forensic Ballistics; D005592:Fracture Fixation / Q000379:methods*; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008889:Military Personnel; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014421:Turkey; D014948:Wounds, Gunshot / Q000601:surgery*