Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Civilian Gunshot Injuries 8 articles


Debate: Gun Control in the United States

Michael Boylan PhD, Don B. Kates JD, Ronald W. Lindsey MD, Zbigniew Gugala MD, PhD

Retained Bullet Removal in Civilian Pelvis and Extremity Gunshot Injuries: A Systematic Review

John T. Riehl MD, Adam Sassoon MD, Keith Connolly BS, George J. Haidukewych MD, Kenneth J. Koval MD

Although gunshot injuries are relatively common, there is little consensus about whether retained bullets or bullet fragments should be removed routinely or only in selected circumstances.

The Initial Trauma Center Fluid Management of Penetrating Injury: A Systematic Review

Nicole M. Tapia MD, James Suliburk MD, Kenneth L. Mattox MD

Damage-control resuscitation is the prevailing trauma resuscitation technique that emphasizes early and aggressive transfusion with balanced ratios of red blood cells (RBCs), plasma (FFP), and platelets (Plt) while minimizing crystalloid resuscitation, which is a departure from Advanced Trauma Life Support (ATLS) guidelines. It is unclear whether the newer approach is superior to the approach recommended by ATLS.

Retrograde Versus Antegrade Intramedullary Nailing of Gunshot Diaphyseal Femur Fractures

Paul J. Dougherty MD, Petra Gherebeh MD, Mark Zekaj BS, Sajiv Sethi BS, Bryant Oliphant MD, Rahul Vaidya MD

The use of retrograde nailing for gunshot wound femur fractures is controversial due to concerns of knee sepsis after this procedure since the knee is entered to introduce the nail into the canal.

Statistical Validity and Clinical Merits of a New Civilian Gunshot Injury Classification

Socrates A. Brito MD, Zbigniew Gugala MD, PhD, Alai Tan MD, PhD, Ronald W. Lindsey MD

Despite the high prevalence of civilian gunshot injuries (GSIs) in the United States, no universally accepted classification currently exists. Recently, two of us (ZG, RWL) proposed a GSI classification based on energy transferred, vital structure damage, wound characteristics, fracture, and degree of contamination. This classification has not been validated in a clinical setting.

Civilian Gunshot Injuries of the Spinal Cord: A Systematic Review of the Current Literature

Gursukhman S. Sidhu MBBS, Arvindera Ghag MD, Vanessa Prokuski BA, Alexander R. Vaccaro PhD, Kristen E. Radcliff MD

The principles that guide management of spinal cord injury (SCI) derive from injury resulting from blunt trauma, not gunshot wounds. Civilian gunshot-induced spinal cord injury (CGSWSCI) is a common, potentially serious cause of neurological deficit; there is disagreement about whether the same approaches used for SCI caused by blunt-force trauma should apply to gunshot-induced SCI.

Antibiotics in the Treatment of Low-velocity Gunshot-induced Fractures: A Systematic Literature Review

Efthymios Papasoulis MD, Michael J. Patzakis MD, Charalampos G. Zalavras MD, PhD

Low-velocity gunshots are often associated with extremity fractures. There is no consensus, however, on the use of antibiotics for these injuries.