Civilian gunshot extremity fractures with neurologic injury

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.

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.

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.

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.