Abdul Qayyum, Mohammad Iqbal, Amir Aziz.
Comparison of evaluation and management of open fractures in shaft of long bones of lower limb caused by bullet and shotgun in adults.
Pak Postgrad Med J Jan ;12(3):130-3.

A prospective study was conducted to review the open fractures of shaft of long bones of lower extremity caused by firearm injuries. This included evaluation of the outcome of fractures caused by bullet and shotgun injuries and to identify measures to reduce the complications. Among the 100 patients, 60 suffered from fracture of femur and 40 with fractures of tibia / fibula. Equal numbers of patients presented with bullet and shotgun injuries. Highest incidence occured in 30-40 years of male population. Majority of patients presented and received initial treatment within first twelve hours after injury. The definite methods of fracture stabilization included, plaster of Paris, pin and plaster, external fixation, intramedullary fixation and dynamic hip screw fixation. Soft tissue coverage was subsequently required by significant number of patients. Total hospital stay, time required for full weight bearing and achieving bony union remained prolonged. Neurovascular injury, wound infection, delayed union; joint stiffness and amputation were frequently seen complications.

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