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Comparison of Injured Structures in Gunshot Wounds and Knife Wounds of the Upper Extremity
Sameer Shetty
Dominic Lombardo
Michael Stephens
Luis Quiroga
Kerri Woodberry
West Virginia University
2023-01-31
Presenter: Sameer Shetty
Affidavit:
This material has not been presented nor published and 90% represents the original work of the student and resident.
Director Name: Kerri Woodberry
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Background:
Gunshot wounds (GSW) and stab wounds (SW) are common penetrating injuries to the upper extremity in the United States. However, their impact and severity on the different anatomic structures have been elusive in the literature. We hypothesize that these two penetrating traumas injure structures differently. This study examines the difference between these two mechanisms and the degree of involvement of anatomic structures.
Methods:
A retrospective study was conducted of patients sustaining penetrating trauma to the upper extremity between January 1, 2010 and December 31, 2019 at our level I trauma center in Morgantown, WV.
Injuries from the fingertips to the scapula were included and aggregated according to the mechanism of injury. Data was gathered regarding the mechanism of penetrating injury (gunshot or stab), structures within the upper extremity damaged (bone, tendon, blood vessel, nerve), hospital and ICU length of stay, and mortality.
Results:
Out of 285 eligible patients, 116 sustained a GSW and 169 had SW. GSWs were associated with longer hospital (4.86 days vs 2.62 days; p<.0005), ICU stays (1.57 days vs 0.64 days; p<.0285), and higher mortality (7 deaths vs 0 deaths; p<.0012). In addition, upper extremity fractures were more commonly found in GSWs than SW (75% vs 8.28%; p<0.0001). Tendon injuries were associated more often in SW than GSW (36.09% vs 11.21%; p<0.0001).
Conclusions:
Future studies could investigate outcomes from injuries between SW and GSW to assess long-term functional outcomes relating to upper extremity trauma as well as optimization of surgical management in such injuries.
