Case 23: Gunshot Tibia Fracture

Abstract

Firearm injuries are increasingly encountered, especially in countries with political instability and uprisings (e.g., Arab spring uprisings). This is in part due to increased availability of weapons to the public. Near-distance and high-velocity missiles are expected to leave extensive soft tissue damage, contamination, and bone comminution. Secondary missiles are generated when the primary bullet or missile impacts objects, such as cortical bone, and cause more damage than the primary missile by taking erratic courses and spreading the energy over a wider area. Open tibial fractures due to gunshots are more apt to be followed by complications even with the universally accepted lines of treatment. The usually confronted complications are bone and soft tissue loss, infection, and nonunion. Judicious staged reconstruction using external skeletal fixation is expected to yield good functional and radiological outcomes.

Clinical photos and radiographs of this case have been provided by courtesy of Dr. Wael A. Azzam, Lecturer of Orthopaedic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt