Update on gunshot wounds to extremities

被引:0
作者
von Lubken, F. [1 ]
Achatz, G. [1 ]
Friemert, B. [1 ]
Mauser, M. [2 ]
Franke, A. [3 ]
Kollig, E. [3 ]
Bieler, D. [3 ]
机构
[1] Bundeswehrkrankenhaus Ulm, Klin Unfallchirurg & Orthopadie Rekonstrukt & Sep, Oberer Eselsberg 40, D-89081 Ulm, Germany
[2] Chris Hani Baragwanath Acad Hosp, Trauma Directorate, Johannesburg, South Africa
[3] Bundeswehrzentralkrankenhaus Koblenz, Klin Unfallchirurg & Orthopadie Wiederherstellung, Verbrennungsmed, Koblenz, South Africa
来源
NOTFALL & RETTUNGSMEDIZIN | 2018年 / 21卷 / 02期
关键词
Gunshot wounds; Fracture; Soft tissue injuries; Debridement; External fixators; INTRALUMINAL ARTERIAL SHUNTS; PROLONGED USE; WAR WOUNDS; INJURIES; FRACTURES; BALLISTICS; EXPERIENCE; MANAGEMENT; MISSILES;
D O I
10.1007/s10049-018-0424-9
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Due to recent rampage and terror attacks in Europe, gunshot wounds have become a focus of attention even though they are still rare in Europe. Approximately 50% of gunshot wounds affect the extremities and to understand the sequelae, a basic knowledge of wound ballistics is indispensable. The energy transmitted from the bullet to the tissue is responsible for the severity of the injury and is dependent on the type of weapon and ammunition. A differentiation is made between low-energy injuries caused, e.g. by pistols and high-energy injuries mostly caused by rifles. The higher energy transfer to the tissue in high-energy injuries, results in a temporary wound cavity in addition to the permanent wound channel with extensive soft tissue damage. High-energy gunshot fractures are also more extensive compared to those of low energy injuries. Debridement seems to be necessary for almost all gunshot wounds. Fractures should be temporarily stabilized with an external fixator due to contamination.
引用
收藏
页码:149 / 163
页数:15
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