Management of Civilian Low-Velocity Gunshot Injuries to an Extremity.

J Bone Joint Surg Am · Jun 02 2021 · Review

Jabara JT, Gannon NP, Vallier HA, Nguyen MP

Department of Orthopaedic Surgery, University of Minnesota, Minneapolis

Orthopaedic Trauma

SUMMARY — THE REDUCTIONThis review notes most civilian low-velocity gunshot extremity fractures can be treated like standard fractures, with intra-articular bullets requiring removal but limited high-quality evidence overall guiding care.
Abstract, as published

➤: Despite an increasing rate of civilian low-velocity gunshot injuries, there remains a lack of evidence-based treatment standards.

➤: Most low-velocity gunshot-induced fractures of the extremity can be managed similarly to non-gunshot-induced fractures, with the goals of restoring function and minimizing complications.

➤: There are a limited number of high-quality studies to support the use of prophylactic antibiotics for nonoperatively treated gunshot wounds.

➤: Intra-articular retained bullets should be removed, while prophylactic irrigation and debridement for a transarticular bullet is not routinely warranted for infection prevention.

➤: Much of the literature on low-velocity gunshot wounds is Level-III or IV evidence, warranting the need for higher-powered, randomized, prospective investigations.

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