Management of gunshot wounds of the foot

Civilian injuries due to firearms are increasing in the United States (1,2). Criminal violence has sharply increased the incidence of high-velocity wounds in civilian practice (1). Gunshot wounds of the foot represent a special circumstance of the broad spectrum of firearm injuries. A fundamental understanding of the wounding mechanisms involving energy transfer is paramount to effective management. Furthermore, adequate care of the gunshot wound of the foot requires careful consideration of its unique anatomical constraints and of the biomechanical issues regarding weight-bearing and the gait cycle to ensure functional recovery. The purpose of this article is to review an approach to the care of gunshot wounds of the foot based on the literature and the authors' experience treating these injuries at San Francisco General Hospital.