SCIENTIFIC ARTICLE Civilian gunshot extremity fractures with neurologic injury

摘要

Objectives:To verify the hypothesis that neurologic injuries are less prevalent in civilian gunshot injuries than that reported in the military literature, and are more likely to occur with concomitant fracture.Methods: In order to investigate the incidence and patient variables of gunshot injury with neurologic injury, a retrospective chart review was performed at a single urban trauma center over a five-year period.Results: One thousand eight hundred and fifty-one patients with gunshot injuries were treated at our center over the five year study period. Of these, 895 patients (48%) had involvement of at least one extremity and 382 (21%) had concomitant fractures. Seventy-four had concomitant neurologic injury. There was a statistically significant difference of 14% (53/382) and 4% (21/513) (P < 0.0001) between the group with fracture (53 patients) and the group without fracture (21 patients), respectively, in the occurrence of neurologic insult.Conclusion: This incidence of neurologic injuries in civilian gunshot injuries is lower than that previously reported in the military population and the presence of a fracture is clearly an additional risk factor for neurologic injury.