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Treatment and Outcomes for Gunshot Wound Humerus Fractures: A Multicenter Analysis.
Adam Haydel1, Eleanor Christianson2, Sam Baum1
1Department of Orthopaedics, Louisiana State University Health Sciences Center and University Medical Center, New Orleans, LA.
Journal of Orthopaedic Trauma
|December 30, 2025
Summary
Gunshot wounds to the humerus treated surgically showed higher rates of suggestive fracture-related infection (FRI), vascular, and nerve injuries compared to non-surgical management. However, surgical intervention did not impact nonunion risk.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Musculoskeletal Injuries
Background:
- Gunshot wounds (GSWs) to the humerus present complex management challenges.
- Understanding the injury profile and outcomes is crucial for optimizing patient care.
Purpose of the Study:
- To analyze the injury characteristics, treatment strategies, and outcomes of humerus GSWs.
- To compare fracture-related infection (FRI) and nonunion rates between surgical and non-surgical management.
Main Methods:
- Retrospective review of 654 patients (≥18 years) with humerus GSWs across 12 academic hospitals (2016-2021).
- Comparison of outcomes based on surgical management (SM) versus non-surgical management (NoSM).
- Multivariable logistic regression used to control for injury severity in FRI analysis.
Main Results:
- Surgical management was associated with higher rates of vascular and nerve injuries.
- Higher prevalence of suggestive FRI in the surgical group (19.9%) compared to non-surgical (4.4%).
- No significant difference in nonunion rates between surgical and non-surgical groups.
Conclusions:
- Humerus GSWs managed surgically had a higher incidence of suggestive FRI and associated injuries.
- Surgical versus non-surgical management did not influence the risk of nonunion.
- Findings highlight increased complication risks with surgical intervention for humerus GSWs.
