Limb salvage after bony and vascular gunshot injuries in a five-week-old infant

Abstract

Combined bony and vascular injuries present challenging problems to orthopaedic and vascular surgeons. The use of temporary intraluminal vascular shunts produces significant reductions in ischaemia time and allows fracture stabilisation to be performed before definitive, delicate vascular repair. We report our management of a five-week-old infant who sustained a comminuted fracture of the femur with arterial and venous injuries in a shooting incident. Paediatric nasogastric feeding tubes were used as temporary vascular shunts to re-establish the distal circulation. Stabilisation of the fracture was then followed by vascular reconstruction and soft-tissue surgery, with a good result. We emphasise the need for skills from several surgical disciplines in the management of complex combined injuries.

Fractures in Children Due to Firearm Activity

“…These studies, although informative, are limited in scope by various parameters. For example, some studies only include a certain geographic area [ 16 , 19 , 20 , 23 , 24 , 25 ], only those admitted to the hospital [ 14 , 19 , 20 , 24 ], short time periods [ 16 , 17 , 23 , 25 ], or difficult fractures [ 15 , 26 ]. Most are either limited to powder firearms [ 14 , 15 , 16 , 17 , 19 , 20 , 23 , 24 , 25 ] or non-powder firearms [ 18 ] and very few studies mention spine fractures [ 14 , 19 ].…”