This study was performed to examine the effect on time to union of retained bullet material near the fracture site in cases of gunshot injury.Īfter obtaining institutional review board approval, all operatively treated gunshot injuries treated at a Level 1 Trauma Center between March 2008 and August 2011 were retrospectively reviewed. It has been our observation that fractures with a substantial amount of retained bullet fragments near the fracture site are at risk for delayed or nonunion.

However, when such projectiles hit bone, they may fragment into multiple smaller pieces that are often retained near the fracture site ( Fig. This type of ammunition is designed to expand in the body cavity, increasing stopping power by making a larger cavity in soft tissue, and prevent over penetration of the intended target. Such statistics demonstrate a changing landscape of gunshot injuries and also correlate with a substantial increase in pre-admission fatality rates 8.Īlthough there is abundant literature on the treatment of high and low energy gunshot wounds (GSW), minimal clinical data is available pertaining to modern hollow point projectiles.

Recent data has shown an increase in the use of higher velocity semiautomatic weapons as well as an increase in the average bullet caliber and type of ammunition involved in metropolitan violent assaults 6, 7. According to the Centers for Disease Control and Prevention, more than 73,000 injuries resulted from firearms in 2011 2. Gunshot wounds are a common cause of trauma in the United States 1.

Shards of war calibre