EXTREMITY GUNSHOT INJURIES TREATED IN AN URBAN CHILDRENS-HOSPITAL

In the years 1985 to 1989 75 children and adolescents presented to an urban children's hospital for treatment of 76 incidents of extremity g unshot wounds. Although the population ranged widely, the ''typical'' patient was a preteen or teenager (n = 70) who was shot in the lower e xtremity (n = 53) with a low velocity handgun (n = 74). No vascular in juries and only two transient nerve injuries accompanied the wounds. O nly 30% of the shots caused fractures. Many (43%) of the patients had other relevant psychosocial or medical problems. Previous treatment fo r other gunshot wounds or trauma had occurred in 27 patients. Although follow-up was not good, no consequent infections were identified. Out patient local wound irrigation with minimal debridement sufficed as tr eatment for entry/exit wounds without contamination or fracture. Intra venous antibiotics are necessary in these wounds only for short-term p rophylactic coverage of fractures. Larger soft tissue wounds, intraart icular foreign bodies, and fracture stabilization require operative tr eatment.