Gunshot Wounds and Orthopaedic Injury at a Pediatric Level I Trauma Center

Area of Science:

• Orthopaedic Surgery
• Pediatric Trauma
• Public Health

Background:

• Firearm-related injuries are a significant cause of pediatric mortality and morbidity.
• Orthopaedic firearm injuries are linked to higher mortality rates, particularly in disadvantaged populations.
• Characterizing these injuries and identifying risk factors is critical for targeted interventions.

Purpose of the Study:

• To characterize the patterns of gunshot wound (GSW) injuries in pediatric patients at a level I trauma center.
• To identify risk factors associated with GSW injuries in affected pediatric populations.
• To analyze trends in pediatric GSW injuries over an 11-year period.

Main Methods:

• Retrospective review of pediatric patients (0-17 years) treated for GSWs from April 2012 to October 2023.
• Classification of orthopaedic injuries into specific anatomical locations (e.g., upper extremity, hand/wrist, femur).
• Statistical analysis using chi-squared tests and linear regression to identify injury trends and associations.

Main Results:

• A total of 283 pediatric GSW patients were analyzed, with 55.8% requiring orthopaedic intervention.
• The annual incidence of pediatric GSWs nearly doubled from 2012-2019 to 2020-2023.
• Most patients requiring orthopaedic intervention were Black or African American (81.6%), and 74.0% were lost to follow-up.

Conclusions:

• Pediatric orthopaedic firearm injuries have significantly increased, nearly doubling in volume.
• These injuries disproportionately impact Black or African American children and are complicated by high rates of lost follow-up.
• Multidisciplinary, orthopaedic-centered care is essential for improving patient follow-up and mitigating long-term complications.