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Transaxial gunshot injuries

A Hirshberg1, J Or, M Stein

  • 1Department of Surgery, Chaim Sheba Medical Center, Tel Aviv University, Ramat Aviv, Israel.

The Journal of Trauma
|September 1, 1996
PubMed
Summary
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Gunshot wounds crossing the truncal midline (transaxial injuries) show higher rates of cardiac, vascular, and spinal damage. These injuries also lead to more complications and significantly higher mortality compared to unilateral trajectories.

Area of Science:

  • Trauma Surgery
  • Ballistics Injury Analysis
  • Emergency Medicine

Background:

  • Gunshot injuries to the torso are a significant cause of morbidity and mortality.
  • Understanding injury patterns is crucial for effective trauma management.
  • Transaxial injuries, crossing the midline, present unique challenges.

Purpose of the Study:

  • To define the clinical characteristics of gunshot injuries across the truncal midline (transaxial injuries).
  • To compare outcomes of transaxial versus unilateral torso gunshot wounds.

Main Methods:

  • Retrospective case-control study.
  • Analysis of 223 patients with torso gunshot injuries at a single trauma center.
  • Comparison of 63 patients with transaxial injuries to 148 patients with unilateral injuries.

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Main Results:

  • Transaxial injuries had significantly higher rates of cardiac (8%), vascular (17%), and spinal (29%) damage.
  • Mortality was significantly higher in the transaxial group (29%).
  • Operative misadventures, including wrong cavity access (10%) and missed injuries (14%), were more frequent in transaxial injuries.

Conclusions:

  • Transaxial bullet trajectories represent a distinct injury pattern.
  • These injuries are associated with a high incidence of major visceral damage.
  • Transaxial injuries correlate with increased intraoperative complications and very high mortality.