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Gunshot wound

V Sterzik, B P Kneubuehl, M Bohnert, F Riva, M Glardon
In medico-legal literature, only a small number of publications deal with lethal injuries caused by shots with modified guns. This might lead to the conclusion that such cases are extremely rare. However, there are cases again and yet again. During the investigation process, the modified gun is of particular importance since it can show an unusual ballistic behaviour. The present paper reports on a suicide of a 60-year-old man, committed with a modified revolver and a lead bullet. The man had a single gunshot wound with entrance at the right temporal bone...
October 15, 2016: International Journal of Legal Medicine
Steven A Sumner, Matthew J Maenner, Christina M Socias, James A Mercy, Paul Silverman, Sandra P Medinilla, Steven S Martin, Likang Xu, Susan D Hillis
INTRODUCTION: Accurately identifying youth at highest risk of firearm violence involvement could permit delivery of focused, comprehensive prevention services. This study explored whether readily available city and state administrative data covering life events before youth firearm violence could elucidate patterns preceding such violence. METHODS: Four hundred twenty-one individuals arrested for homicide, attempted homicide, aggravated assault, or robbery with a firearm committed in Wilmington, Delaware, from January 1, 2009 to May 21, 2014, were matched 1:3 to 1,259 Wilmington resident controls on birth year and sex...
September 8, 2016: American Journal of Preventive Medicine
Chad Turner, Shane Hiatt, Brian Mullis
Commonly accepted dogma is that patients with a long bone fracture due to a penetrating injury (gunshot wound) are less likely to follow up than blunt trauma patients. An institutional trauma database from a Level 1 academic trauma center was utilized to include all patients with long bone fractures from penetrating trauma from 2006-2009 (N = 132). Demographically matched blunt trauma patients with long bone fractures were included as a comparison group (N = 104). The medical records of these 236 patients were reviewed to observe their follow-up at 3, 6, 9, and 12 months...
September 2016: American Journal of Orthopedics
Myles R McKenzie, Ernest W Parrish, Ethan A Miles, James C Spradling, Lanny F Littlejohn, Mark D Quinlan, George A Barbee, David R King
During an assault on an extremely remote target, a US Special Operations Soldier sustained multiple gunshot and fragmentation wounds to the thorax, resulting in a traumatic arrest and subsequent survival. His care, including care under fire, tactical field care, tactical evacuation care, and Role III, IV, and V care, is presented. The case is used to illustrate the complex dynamics of Special Operations care on the modern battlefield and the exceptional outcomes possible when evidence-based medicine is taken to the warfighter with effective, farforward, expeditionary medical-force projection...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Joel M Fahling, L Kendall McKenzie
BACKGROUND: The oculocardiac reflex is a decrease in heart rate caused by ocular compression or traction upon the extraocular musculature. Multiple instances of this phenomenon have been described in anesthesia, trauma, craniofacial, and ophthalmology literature, but there is a sparsity of documentation in the emergency medicine literature. CASE REPORT: We describe the observation and management of the oculocardiac reflex in a 26-year-old man with retrobulbar hematoma and intraocular trauma caused by a self-inflicted gunshot wound...
October 8, 2016: Journal of Emergency Medicine
(no author information available yet)
It has been known for some time that common principles should be applied to the management of civilian and military trauma, even though the differences in presentation can be significant. Civilian trauma predominantly presents as blunt trauma, for example from road collisions, whereas military trauma generally comprises blast and gunshot wounds.
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
S M Balaji
Ballistic injuries of oral and maxillofacial region are usually fatal due to close propinquity with the vital structures. The severity of injury depends on the caliber of the weapon used and distance from which the patient is shot. The preliminary care of facial ballistic wounds strictly adheres to the basics of trauma resuscitation. Early and appropriate surgical management has proved to be influential on the final outcome and esthetic result. Treatment of facial gunshot wounds should be planned and carried out carefully to avoid esthetic complications...
July 2016: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Emma Nally, James Jelinek, Robert D Bunning
Lead toxicity in adults is characterized by nonspecific symptoms of abdominal pain, vomiting, constipation, fatigue, and weight loss. We present a case of severe lead toxicity that developed sub-acutely causing quadriparesis nine years after a gun shot wound with retained bullet fragments. The onset of symptoms may have been related to the development of a pseudocyst. The long interval between the gunshot wound and the onset of symptoms contributed to a delay in suspecting that the retained bullet was a source of lead toxicity...
October 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Harriet Kiwanuka, Mario A Aycart, David F Gitlin, Elaine Devine, Bridget J Perry, Thet-Su Win, Ericka M Bueno, Muayyad Alhefzi, Nicco Krezdorn, Bohdan Pomahac
BACKGROUND: Facial self-inflicted gunshot wounds (SIGSWs) cause a devastating midfacial defect and pose a challenging problem to the reconstructive surgeon. Face transplantation (FT) has the potential for near-normal restoration in otherwise non-reconstructible defects. Two out of 7 FT recipients at Brigham and Women's Hospital (BWH) sustained SIGSWs. In this study, we illustrate the role of FT in the management of SIGSWs through an aesthetic, functional, and psychosocial examination of outcomes...
September 8, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ali Babashahi, Morteza Taheri
Spinal kyphotic deformity after spinal laminectomy or laminoplasty is more common in pediatric patients than adults. Laminectomy can lead to decreased cartilage growth, anterior wedging and posterior spinal muscle insufficiency which can result in kyphotic deformity. Herein we outline a case report of a child presenting with kyphotic deformity after receiving a spinal laminectomy to treat a penetrating spinal trauma. The 8-year-old male presented with penetrating spinal trauma following a gunshot wound and subsequently underwent L1 laminectomy and thecal sac decompression to remove the foreign body...
March 2016: J Spine Surg
Koffi Benjamin Manou, Ndoula Espérance Kounkou, Romaric Toe, Awo Dorcas Akadje, Cisse Ali, Amonso Daniel Alloh, Manse Béatrice Nandjui
OBJECTIVE: The quality of the residual limb of the amputations in the consequences of a ballistic trauma often was compromised and limits the success of a good equipment for a satisfactory locomotive function. The objective of the study is to describe the various anomalies of the residual limb and their difficulty of equipment of the traumatic amputations by bal PATIENTS AND METHODS: A descriptive retrospective study concerned patients amputated of lower limbs in the consequences of a ballistic trauma during the military crisis in Ivory Coast from 2010 to 2012 and dealt in the center of equipment "Vivre Debout" in the Teacher Hospital of Yopougon...
September 2016: Annals of Physical and Rehabilitation Medicine
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
Ilan Igor Maizlin, Jerry S Chen, Nicholas James Smith, David A Rogers
Posttraumatic esophagomediastinal fistula is an uncommon clinical entity that warrants surgical awareness due to its life-threatening potential. Its management, especially in previously operated field, is controversial and several endoscopic methods are being proposed as alternatives. Ours is the first report of endoscopic fulguration and fibrin injection in successful closure of such fistula. A 9-year-old female sustained complete tracheoesophageal transection from a gunshot wound to the neck and underwent immediate primary repair...
September 2016: American Surgeon
M J Ramdass, P Harnarayan
INTRODUCTION Trinidad and Tobago is a trans-shipment point for the illegal trade of drugs, arms and ammunition and, as such, has a high incidence of gang-related warfare and drug-related crimes. This has led to a high incidence of gunshot and stab wounds, with associated major vascular injuries. We describe our management strategies learned from a decade of vascular trauma experience. METHODS A retrospective analysis of age, gender, type of trauma, vessel injured, procedure and outcome for all cases of vascular trauma between 2006 and 2015 at two surgical units in Trinidad and Tobago...
September 23, 2016: Annals of the Royal College of Surgeons of England
B Shazi, J L Bruce, G L Laing, B Sartorius, D L Clarke
INTRODUCTION The purpose of this study was to audit our current management of colonic trauma, and to review our experience of colonic trauma in patients who underwent initial damage control (DC) surgery. METHODS All patients treated for colonic trauma between January 2012 and December 2014 by the Pietermaritzburg Metropolitan Trauma Service were included in the study. Data reviewed included mechanism of injury, method of management (primary repair [PR], primary diversion [PD] or DC) and outcome (complications and mortality rate)...
September 23, 2016: Annals of the Royal College of Surgeons of England
Bilge Kagan Aysal, Abdulkerim Yapici, Yalcin Bayram, Fatih Zor
Facial nerve is the main cranial nerve for the innervation of facial expression muscles. Main trunk of facial nerve passes approximately 1 to 2 cm deep to tragal pointer. In some patients, where a patient has multiple operations, fibrosis due to previous operations may change the natural anatomy and direction of the branches of facial nerve. A 22-year-old male patient had 2 operations for mandibular reconstruction after gunshot wound. During the second operation, there was a possible injury to the marginal mandibular nerve and a nerve stimulator was used intraoperatively to monitor the nerve at the tragal pointer because the excitability of the distal segments remains intact for 24 to 48 hours after nerve injuries...
October 2016: Journal of Craniofacial Surgery
André Luis Ribeiro Ribeiro, Luciana Campêlo da Silva Gillet, Hiam Ghassan de Vasconcelos, Luciana de Castro Rodrigues, João de Jesus Viana Pinheiro, Sérgio de Melo Alves-Junior
PURPOSE: Facial fractures are an important health problem worldwide that can cause temporary or permanent disability and an economic burden. Identifying the risk factors associated with facial fractures is a valuable tool to create preventive public health strategies. This study evaluated the epidemiologic profile of facial fractures in northern Brazil. PATIENTS AND METHODS: Medical records of 1,969 patients who sustained facial fractures were analyzed for characteristics of the population, types of facial fractures, and treatment performed...
August 25, 2016: Journal of Oral and Maxillofacial Surgery
John P Begly, Claudette M Lajam
A 35-year-old female presented to orthopaedic clinic with a chief complaint of chronic left hip pain, beginning 17 years prior when she had sustained a gunshot wound to her left buttock. Imaging demonstrated significant left hip arthritis with a retained projectile in the femoral head. Lead levels were also found to be significantly elevated. The patient underwent successful left total hip arthroplasty, with subsequent postoperative pain relief and consistent decrease in serum lead level. This report presents a rare case that emphasizes lead intoxication as a potentially dangerous complication of gunshot wounds and retained projectiles in the orthopaedic patient...
September 2016: Bulletin of the Hospital for Joint Diseases
Matthew Wordsworth, Rachael Thomas, John Breeze, Demetrius Evriviades, James Baden, Shehan Hettiaratchy
INTRODUCTION: The recent Afghanistan conflict caused a higher proportion of casualties with facial injuries due to both the increasing effectiveness of combat body armour and the insurgent use of the improvised explosive device (IED). The aim of this study was to describe all injuries to the face sustained by UK service personnel from blast or gunshot wounds during the highest intensity period of combat operations in Afghanistan. METHODS: Hospital records and Joint Theatre Trauma Registry data were collected for all UK service personnel killed or wounded by blast and gunshot wounds in Afghanistan between 01 April 2006 and 01 March 2013...
August 20, 2016: Injury
Naoko Tanaka, Hiroshi Kinoshita, Ayaka Takakura, Mostofa Jamal, Asuka Ito, Mitsuru Kumihashi, Kunihiko Tsutsui, Shoji Kimura, Kiyoshi Ameno
We investigated gunshot wounds in two autopsy cases using energy dispersive X-ray spectrometry (EDX). Lead and copper were detected in the entrance wound of one case and lead, antimony, and copper were detected in that of the other case. In the exit wounds of both cases, lead, antimony, and copper were below detection limits. These findings indicate that the detection of metallic elements, such as lead, antimony, and copper, which are found in bullets, may be useful for differentiating entrance from exit wounds using EDX...
September 2016: Legal Medicine
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