The management of gunshot fractures of the extremities

The treatment of 61 fractures of the extremities resulting from low velocity gunshot wounds is reviewed to evaluate the wisdom of the concept of a limited approach to the treatment of civilian gunshot injuries. The great majority of the wounds were treated successfully by superficial care, antibiotics, and immobilization. However, one fracture, after normal healing of the soft tissue wound, was complicated by an infected pseudarthrosis that occurred after two unsuccessful internal fixations, and in another case there was a failed internal fixation but the patient refused further surgery. Our experience with two cases that required formal debridement also suggests that, although the concept of limited wound care for low velocity gunshot wounds is valid, caution is advisable in its application.