Scientific ArticleGunshot-Related Upper Extremity Nerve Injuries at a Level 1 Trauma Center
Section snippets
Materials and Methods
The University of Chicago institutional review board approved study of patients over 16 years of age presenting with gunshot-related traumatic injury to the upper extremities at our level 1 trauma center. Between May 2018 and May 2019, 1,302 patients presented to our institution as trauma level activations. All patients identified as having upper extremity ballistic trauma were included in this study. Reviews of the University of Chicago orthopaedic and general surgery trauma databases were
Results
Our trauma center treated ballistic injuries in 1,302 patients over a 12-month period. Of these, 650 patients were coded with extremity gunshot wounds in an audit of our general surgery trauma database. Upon detailed chart review, 113 patients had superficial gunshot wounds that did not breach the fascia and were excluded. Of all ballistic trauma activations, an additional 135 patients (10%) were initially coded as extremity gunshot injuries by the trauma research staff, in most cases because
Discussion
Gunshot wounds to the extremities can lead to permanent neurovascular injury, chronic pain, and disability.7,13, 14, 15, 16, 17 The mechanism of nerve injury from ballistic missiles has been described as both a direct impact from the projectile traveling through tissue, as well as the shock wave and cavitation that expands the zone of injury, but reports of the frequency of nerve palsy are highly variable.14,18, 19, 20, 21 Nerve injuries after gunshot wounds have been previously reported; a
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