Wound ballistics of firearm-related injuries—Part 2: Mechanisms of skeletal injury and characteristics of maxillofacial ballistic trauma

Stefanopoulos, Panagiotis K.; Soupiou, O.T.; Pazarakiotis, V.C.; Filippakis, K.

doi:10.1016/j.ijom.2014.07.012

Cited by 35 publications

(24 citation statements)

References 90 publications

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“…Unlike soft tissues, bone offers more resistance against penetration by a bullet due to its composition, hardness, density and strength (Bartlett 2003;Janzon et al 1997;Stefanopoulos et al 2015). Due to its nature, bone tissue cannot absorb the energy transferred from a bullet to the extent in which soft tissues do.…”

Section: Discussionmentioning

confidence: 99%

“…Due to its nature, bone tissue cannot absorb the energy transferred from a bullet to the extent in which soft tissues do. Instead, bones act like a brittle material (Kieser et al 2014;Stefanopoulos et al 2015), when the stress/strain is beyond that they can rebound from, fractures occur. Ballistics fractures fall within sudden force and high speed category (Chapman 2007;Hamblen et al 2007), and such fractures could result from direct impact of projectiles with excessive speed or a projectile at a vulnerable point in the bone (Byers 2015;Chapman 2007).…”

Section: Discussionmentioning

confidence: 99%

“…Unlike in soft tissues, the temporary cavity in bone tissue is not followed by the collapse of the cavity, rather the lack of elasticity causing a pulverisation effect to the bone (i.e. fracture) (Huelke et al 1968;Janzon et al 1997;Stefanopoulos et al 2015). The transfer of energy to bone in ballistic injuries is less understood (Kieser et al 2014;Molde and Gray 1995;Stefanopoulos et al 2015), in comparison to that in soft tissues.…”

Section: Discussionmentioning

confidence: 99%

“…fracture) (Huelke et al 1968;Janzon et al 1997;Stefanopoulos et al 2015). The transfer of energy to bone in ballistic injuries is less understood (Kieser et al 2014;Molde and Gray 1995;Stefanopoulos et al 2015), in comparison to that in soft tissues. The soft tissues, due to their elastic properties, are able to absorb the energy transferred and revert back to their normal state, unless their elasticity is overcome.…”

Section: Discussionmentioning

confidence: 99%

“…When it comes to bony injuries from projectiles, a lot of research has been conducted into maxillofacial ballistics trauma (Berryman et al 1995;Lahren et al 1987;Stefanopoulos et al 2015;Viel et al 2009). The literature has been able to document the characteristics of projectile skeletal trauma to the skull as well as soft tissue characteristics, however minimal details on the thorax/ abdomen bony regions in particular the scapula, ribs, sternum and vertebrae have been published (Langley 2007).…”

Section: Introductionmentioning

confidence: 99%

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Anthropological analysis of projectile trauma to the bony regions of the trunk

Humphrey¹,

Henneberg²

2017

Anthropological Review

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Ballistics literature often focuses on soft tissue injures and projectile trauma to the cranium. Minimal details on the bony characteristics of projectile trauma to the thorax/abdomen regions have been published. This study aims to analyse projectile trauma to the bony trunk region including the ribs, vertebrae, scapula, sternum and the hip bone to form a better understanding of the characteristics and biomechanics of skeletal trauma caused by a projectile and contribute to the existing database on skeletal trauma caused by projectiles. Fourteen cases of documented projectile trauma to the bony regions of the trunk from the Hamman-Todd Human Osteological Collection at the Cleveland Natural History Museum, Ohio were analysed. Of the 14 individuals with gunshot wounds examined, 40 wounds occurred to the bones. Twenty-four injuries to the ribs, 1 ilium, 11 vertebrae, 3 scapulae, and 1 sternum. Fracture patterns, heaving and bevelling can be used to determine the direction of travel of the projectile which can be evident on the ribs, sternum, scapula and ilium. It is critical to understand the wounding patterns associated with projectile trauma to the torso region as this is often targeted, due to being the centre of mass.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anthropological analysis of projectile trauma to the bony regions of the trunk

Humphrey¹,

Henneberg²

2017

Anthropological Review

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Maxillofacial Gunshot Wounds (GSW)

Terres¹,

Haggerty²

2022

Atlas of Operative Oral and Maxillofacial Surgery

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Microsurgical reconstruction of complex maxillofacial gunshot wounds: Outcomes analysis and algorithm

Gürünlüoğlu

Gatherwright

2019

Microsurgery

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Background Satisfaction with appearance, functional outcomes (speech, swallowing), work status after microsurgical reconstruction for maxillofacial gunshot wounds (GSW) remain largely unknown. The purpose of this study is to report these parameters. By investigating these outcomes, we also aimed to provide microsurgical algorithms for complex maxillofacial GSW. Methods Forty‐two consecutive maxillofacial GSW patients between 2006 and 2014 were analyzed for outcomes. Mean age was 41.3 years ranging 14 to 77 years. There were 33 males and 9 females. Results Twenty‐four patients received 36 free flaps for early reconstruction in 1 to 2 weeks, two patients in a delayed manner. Fifteen fibula flaps for mandible reconstruction, five fibula, there radial forearm (RF), and two scapular osteocutaneous (OC) flaps for maxilla reconstruction, two RF flaps for palate reconstruction, one RF for cheek reconstruction were used. Four patients underwent innervated gracilis flap for total lower lip and one for cheek reconstruction. Rectus abdominis myocutaneous flap was used for mid‐face defects in two patients. One anterolateral thigh flap was used for lower lip/chin reconstruction. Nine free flaps were performed to treat a complication and/or to improve function. All flaps survived except for three partial skin paddle loss to fibula flaps. Mean follow‐up was 17.2 months. Return to work/school was 70%. Surveys noted 58% “satisfied”. All patients but two achieved perceptible speech, the majority had no difficulty with swallowing, all patients had oral competence. Conclusions Favorable outcomes were obtained in most maxillofacial GSW. After investigating these outcomes, microsurgical algorithms were developed for clinical practice for reconstruction of composite mandible and total‐lower lip defects, and maxilla/mid‐face defects.

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Wound ballistics of firearm-related injuries—Part 2: Mechanisms of skeletal injury and characteristics of maxillofacial ballistic trauma

Cited by 35 publications

References 90 publications

Anthropological analysis of projectile trauma to the bony regions of the trunk

Anthropological analysis of projectile trauma to the bony regions of the trunk

Maxillofacial Gunshot Wounds (GSW)

Microsurgical reconstruction of complex maxillofacial gunshot wounds: Outcomes analysis and algorithm

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