Abstract
Background
Little is known regarding risk factors specific to pediatric upper extremity firearm injuries. The purpose of this study is to evaluate pediatric patients treated for these injuries to identify at-risk populations and recurring mechanisms of injury.
Methods
A 20-year retrospective review was conducted. Patients 17 years of age and younger, with upper extremity injuries related to a firearm, were included. Analysis involved Fisher’s exact and Chi-square tests.
Results
One hundred and eighty patients were included. The mean age was 12.04 ± 4.3 years. Most included patients were male (85%). Interestingly, females were more frequently victims of assault (P = 0.03), and males were more frequently injured due to accidental discharge (P < 0.001). The most affected race/ethnicity was White-not Hispanic or Latino (48%). The hand was the most frequent location injured (31%) and was more likely to be accidental than proximal injuries (P = 0.003). Air rifles were the most common firearm type used (56%). Pistols were implicated in 47 (26%) cases, rifles in 17 (9%), and shotguns in 10 (6%). Ninety-nine (55%) patients had procedures in the operating room. The most frequent procedure was foreign body removal (55%).
Conclusions
Risk factors such as male sex, White-not Hispanic or Latino race/ethnicity, and adolescent age were attributed to increased risk for injury. Male sex was associated with increased risk of injury by accidental discharge and female sex with intentional assault. Air rifles were the most common firearm type overall, although female sex was associated with increased risk for injury by powder weapon.
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This research did not receive any specific grant or funding from agencies in the public, commercial, or not-for-profit sectors.
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NDS contributed to conceptualization, methodology, data curation, formal analysis, investigation, writing of original draft, reviewing and editing. AM contributed to conceptualization, data curation, formal analysis, investigation, and writing of original draft. KC contributed to conceptualization, data curation, formal analysis, investigation, writing of original draft, reviewing and editing. KD and CH contributed to conceptualization, writing of original draft, reviewing and editing. SE contributed to conceptualization, methodology, formal analysis, investigation, writing of original draft, reviewing and editing, and supervision. All authors contributed to final approval of this manuscript.
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Ethical approval
This investigation was IRB approved (IRB 201903454) by the University of Florida. Specifically, the study was awarded exempt approval. For all patients undergoing treatment at the University of Florida, consent was obtained from the patient (or their parent or legal guardian in the case of children under 16) for treatment and the inclusion of data for retrospective research.
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No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. The authors have no conflict of interest to declare.
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The datasets generated during and/or analyzed during the current study are not publicly available due to included participants’ privacy but are available from the corresponding author on reasonable request.
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Nichols, D.S., Audate, M., King, C. et al. Pediatric upper extremity firearm injuries: an analysis of demographic factors and recurring mechanisms of injury. World J Pediatr 17, 527–535 (2021). https://doi.org/10.1007/s12519-021-00462-9
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DOI: https://doi.org/10.1007/s12519-021-00462-9