title: In the line of fire--21st-century approach to an ancient war injury.
abstract: Authentic black-powder muzzle-loader weapons or replicas are used today primarily for re-enactments of historic battles. A lay actor playing the role of a Prussian infantryman sustained life-threatening gunshot injuries during a recent re-enactment of a historic battle of the Sixth Coalition. As only blank historic muzzle-loading weaponry was used, the origin of the missile causing the wounding was initially unclear. Further investigation revealed a ramrod that had been propelled out of the barrel of another gunner's smooth-bore gun as cause of injury. The ramrod was hurled on a trajectory of more than 20 m, breaking the victim's shouldered barrel and hitting the victim resulting in severe abdominal, thoracic, and upper limb injuries. The critical incidents while handling muzzle-loading weaponry leading to premature discharge are elucidated. Furthermore, this report demonstrates how actual diagnostics and subsequent surgical treatment enabled this infantryman to survive an injury to which his comrades-in-arms would have succumbed 200 years ago.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Ernst-Moritz-Arndt-University Greifswald, 17475 Greifswald, Germany. matthias.frank@uni-greifswald.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Frank
authors.forename: Grit
authors.initials: G
authors.lastname: Rademacher
authors.forename: Uli
authors.initials: U
authors.lastname: Schmucker
authors.forename: Stephan
authors.initials: S
authors.lastname: David
authors.forename: Axel
authors.initials: A
authors.lastname: Ekkernkamp
mesh_terms: D000059:Accidents; D004867:Equipment Design; D005389:Firearms / Q000266:history*; D049672:History, 19th Century; D006801:Humans; D006810:Humeral Fractures / Q000473:pathology / Q000601:surgery; D008099:Liver / Q000293:injuries / Q000473:pathology / Q000601:surgery; D055370:Lung Injury / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012253:Rib Fractures / Q000473:pathology / Q000601:surgery; D014948:Wounds, Gunshot / Q000473:pathology*