Sherif Dabash, Chris Gerzina, Joshua E. Simson, Ahmed
Elabd, Amr A. Abdelgawad, Miguel Pirela-Cruz, Department
of Orthopaedic Surgery & Rehabilitation, Paul L. Foster School of
Medicine, Texas Tech University Health Sciences Center, El Paso,
TX, the Unites States.
Confict-of-interest statement: The author(s) declare(s) that there
is no confict of interest regarding the publication of this paper.
Open-Access: This article is an open-access article which was
selected by an in-house editor and fully peer-reviewed by external
reviewers. It is distributed in accordance with the Creative Com-
mons Attribution Non Commercial (CC BY-NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non-
commercially, and license their derivative works on different terms,
provided the original work is properly cited and the use is non-
commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Amr Abdelgawad, MD, Associate Profes-
sor, Chairman, Department of Orthopaedic Surgery & Rehabilita-
tion, Texas Tech University Health Sciences Center El Paso, Paul
L. Foster School of Medicine, 4801 Alberta Avenue, El Paso, Texas
79905, the Unites States.
Email: amr.abdelgawad@ttuhsc.edu
Telephone: +1-915-215-5406
Fax: +1-915-545-6704
Received: March 27, 2018
Revised: April 9, 2018
Accepted: April 11 2018
Published online: April 28, 2018
ABSTRACT
BACKGROUND: Gunshot wounds to the upper extremity in
pediatric patients are an uncommon injury, but their impact on the
patient can be severe. They can be accompanied by nerve damage,
bone fracture, or tendon rupture. The most common cause of these
pediatric gun injuries is unintentional frearm discharge. The most
common type of firearm involved overall is a powdered weapon;
however, non-powder weapons are a significant contributor to
pediatric frearm injury. The purpose of this study is to describe the
characteristics and treatment outcomes of pediatric GSW in a level
one trauma center on the US-Mexican border.
METHODS: Retrospective case series.
RESULTS: Ten patients met our inclusion criteria for the study.
The most frequent mechanism of injury was due to violence (60%),
and the most frequent type of firearm involved was a powdered
weapon (80%). Males were more affected than females (70%).
Six patients experienced bone fracture, three patients experienced
nerve damage, and one patient experienced tendon damage. No
patients had lasting physical deficits as the result of their injury.
CONCLUSION: Most of the pediatric GSW (60%) were due to
violence. However, a significant percentage was due to accidental
injury (40%). Addressing powder and non-powder weapon safety is
warranted to reduce frearm injury in the pediatric population. Good
outcomes can be expected in most pediatric GSW.
Key words: Pediatric gunshot wound; Violence; Trauma; Firearms;
Upper extremity
© 2018 The Author(s). Published by ACT Publishing Group Ltd. All
rights reserved.
Dabash S, Gerzina C, Simson JE, Elabd A, Abdelgawad AA, Pierla-
Cruz MA. Pediatric Gunshot Wounds of the Upper Extremity.
International Journal of Orthopaedics 2018; 5(2): 910-915 Available
from: URL: http://www.ghrnet.org/index.php/ijo/article/view/2302
INTRODUCTION
Firearm injuries are a possible cause of morbidity and mortality in
pediatric patients
[1]
. These injuries can take an emotional and fnancial
toll on the affected children and their families and may involve joints,
bones, neurovascular structures, and the soft tissues encompassing
these structures
[2]
. In 2009, injury-related deaths of adolescents 15
through 19 years of age had a frearm-related rate of 28.8%. These
deaths included injuries resulting from homicide, suicide, and
unintentional injury
[3]
. In 2015, the mortality rate of frearm injury in
patients under 18 years old was 9.1%
[4]
. These injuries can be caused
by projectiles from conventional powder propelled weapons as well
as from non-powder weapons (e.g. BBs, pellets, airsoft ammunition,
CASE REPORT
Pediatric Gunshot Wounds of the Upper Extremity
Sherif Dabash, Chris Gerzina, Joshua E. Simson, Ahmed Elabd, Amr A. Abdelgawad, Miguel Pirela-Cruz
910
Int. J. of Orth. 2018 April 28; 5(2): 910-915
ISSN 2311-5106 (Print), ISSN 2313-1462 (Online)
Online Submissions: http: //www.ghrnet.org/index.php/ijo
doi: 10.17554/j.issn.2311-5106.2018.05.269
International Journal of Orthopaedics