Wound ballistics 101: the mechanisms of soft tissue wounding by bullets

Stefanopoulos, Panagiotis K.; Pinialidis, Dionisios; Hadjigeorgiou, Georgios F.; Filippakis, K.

doi:10.1007/s00068-015-0581-1

Cited by 68 publications

(93 citation statements)

References 39 publications

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“…High velocity weapons have greater kinetic energy and consequent potential to destroy tissue as a result of the temporary cavitation induced once the bullet becomes deformed. Bullet fragmentation and bony fractures are predictors of increased wound severity whereas low velocity bullet causes damage limited to the bullet's path mainly as a result of localized crush injury [18,19]. The distance from the source of weapon and the intervention done had no statistical significance on the outcome.…”

Section: Discussionmentioning

confidence: 98%

Civilian Gunshot Injuries: Experience from Sokoto, North-West, Nigeria

Oboirien¹,

Sp²

2016

J Trauma Treat

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Introduction: The Proliferation of small arms in the West African sub-region and the activities of insurgent groups and rustlers have caused renewed interest in Gunshot injuries. We aim to document the trend and outcome of such injuries in our sub-region. Methods: It was a prospective study of cases of gunshot injuries admitted at the University Teaching hospital over a period of 18 months. Parameters analysed included patients' bio-data, region of the body affected, mechanism and source of projectile, clinical presentations and short term outcome. Statistical analysis was done with IBM SPSS 20. Level of significance was p<0.05. Results: A total of 43 patients were seen with a mean age of 33.76 ± 10.59. There were 42(97.7%) males and 1(2.3%) female. The victims were mostly farmers (25%), professional drivers (13.6%), Students (11.4%). The body region affected were the lower extremity (36.4%), upper extremity (27.3%), Most of the cases were from armed robbery attack (77.3%) and Assaults (13.6%). Low velocity weapons like Dane guns were the common sources of projectile 95.3%. High velocity weapon like AK 47 was used in 4.7% of cases. Majority of victims were shot at closed range (86.4%) and 79.5% were stable on presentation. Intervention carried out included wound debridement (65.9%), external fixation (23%), and chest tube drainage (9.1%). The outcome was such that 68.2% survived without residual deficit while 31.8% survived with residual deficit. Conclusion: Gunshot injuries were mainly from armed robbery attack using low velocity weapon with farmers being the most victims. Strict regulations in the acquisition and use of light firearms would reduce the incidence of armed robbery and gun related violence in our sub region.

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Section: Discussionmentioning

confidence: 98%

Civilian Gunshot Injuries: Experience from Sokoto, North-West, Nigeria

Oboirien¹,

Sp²

2016

J Trauma Treat

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“…As a result, the faster a bullet is fired, the more KE is generated, increasing the potential tissue damage. Because the muzzle velocity of the bullet is defined by the length of the barrel and the explosive quantity [12], handguns with short barrel lengths yield lower velocity (less than 609.6 m/sec), whereas rifles with longer barrel lengths produce a higher velocity (609.6 m/sec or faster) [8,9,11]. As for our patient, neither the type of weapon used nor the exact distance between the weapon and the body was officially confirmed because the assailant has not been arrested, and details of the incident under investigation are not allowed to be disclosed.…”

Section: Discussionmentioning

confidence: 99%

“…Wounds generated by bullets are determined via their direct and indirect interactions with living tissues (Fig. 4) [8,10,12]. "Direct damage", also called "prompt damage", occurs with the rapid distension and rupture of tissue generated by the leading edge of the bullet passing through [8,10].…”

Section: Discussionmentioning

confidence: 99%

“…"Direct damage", also called "prompt damage", occurs with the rapid distension and rupture of tissue generated by the leading edge of the bullet passing through [8,10]. This effect creates a "crush cavity", also referred to as a "permanent cavity", corresponding to the central area of tissues disrupted along the projectile's track [8,9,11,12]. On the other hand, "indirect damage" develops without direct contact between the tissue and projectile through a pair of highly dynamic pressure phenomena referred to as "stretch cavity formation" (also termed "temporary cavitation") and "shock wave" (also called "sonic pressure wave") [8,9,11,12].…”

Section: Discussionmentioning

confidence: 99%

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Atypical gunshot injury to the neck with an unexpected nonlinear bullet trajectory: a case report and review of the literature

Matsui

Iguchi

Sato

et al. 2020

Preprint

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Background Gunshot injuries involving the head and neck region yield profound morbidity and mortality rates because of the region’s dense structure occupied with essential organs. Both projectile- and tissue-related factors determine the disruptive effects of projectiles on living tissues, with the former comprising various physical and dynamic properties of a bullet. Although a bullet generally passes straight through the body, we experienced an unusual case of a gunshot injury to the neck, wherein the bullet penetrated through the deep structures to the contralateral side of the shoulder without damaging any vital organs, allowing us to discuss the diagnostic implications of wound ballistics in managing gunshot wounds with unexpected bullet trajectories. Case presentation A 51-year-old man presented with a gunshot wound to the neck from a point-blank range shooting during a local gang conflict. On admission, a bullet entry hole was observed on the left side of the neck without an exit hole; however, the patient was conscious; vital signs were normal; and no active bleeding, cranial nerve palsy, or aero-digestive tract injury were found. Imaging tests revealed a bullet lying in front of the right humeral head, a comminuted fracture of the right clavicle, and soft tissue edema and small air sacs among the deep neck structures, including the retropharyngeal space. Emergency surgery was performed to extract the bullet, which turned out to be a full metal-jacketed bullet. Five days later, the patient was uneventfully discharged. According to the localization of the damaged tissues and the positional relationship between the bullet’s entrance and its destination, we estimated that the bullet nonlinearly penetrated the neck through the interstructural spaces associated with the least tissue resistance, almost transversely, during its intra-body movement. Conclusion Our experience strongly suggests the importance of realizing the unpredictable nature of a bullet trajectory in a body. Awareness of various ballistic factors and wounding mechanisms, which affect a bullet trajectory and the magnitude of tissue damage, can be of great help in adequate assessment and management of patients with gunshot injuries.

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“…In the first manuscript, Stefanopoulos et al present a comprehensive review on wound ballistics [2]. Information is [5].…”

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confidence: 99%