Hunting Guns and City or War Weapons Injuries: Assessment, Management, 59 Cases

Introduction: Any doctor treating trauma victims should have a basic understanding of the mechanisms involved in such injuries. The wounding effects of projectiles are determined by: 1. Physical properties of the missile -mass, shape, composition, 2. Flight characteristics-velocity stability & yaw or tumbling characteristics, 3.The reaction of the differing types of tissue (elasticity-density). Depending the above reported parameters, in the present study, we classified and examine the 3 following types of gunshot injuries: I) Hunting guns injuries, II) City-low energy weapon injuries, III) War weapon-high energy injuries.

Methodology and Material: 59 cases had been operated and managed in our Departments in past 10 years(56 hands, 4 legs and feet), I) 25 of them caused to hunting shotguns, II) 13 of them caused to War weapons (Kalashnikov, M16 rifle, uzi gun, magnum), and III) 20 to low energy shotguns (9,22,45 mm pistol). We classified and assessed the gravity of the injuries, and we remark the type and the effectiveness of the management.

Results: 5 of victims belonging to the first category (I) finally arrived to partial amputation of the limb. The rest of the category I and 10 from the category II need to be operated more than 1 time, performing complex reconstruction and combining revascularization, skin, nerve (3 cases) or bone grafts (4 cases), flaps (1 cases), free flap (1 case) external fixation for immobilization or bone lengthening (1 case). In the last category simpler reconstructive procedures had been requested.

Conclusions: The most grave type of gunshot injuries seems to be those caused by hunting shotguns-especially when they are caused by a short distance (crush injuries) which could cause limb partial or complete amputation, following the high energy war rifle injuries causing complex injuries which involves bone, nerve, muscle and vessels and very often need to be operated by microsurgeons more than one time and to perform complex reconstruction by revascularization, grafts and flaps, and the city guns injuries which usually cause less destructive results.