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Anales de la Facultad de Medicina

versión On-line ISSN 2301-1254

Resumen

PUCHIELE, Andrés; AZZIZ, Alejandro  y  CASALES, Nicolás. Treatment of gunshot wound fractures: Systematic Review of the literature. Anfamed [online]. 2023, vol.10, n.1, e303.  Epub 01-Jun-2023. ISSN 2301-1254.  https://doi.org/10.25184/anfamed2023v10n1a9.

Introduction:

Fractures due to gunshot wounds are a common reason for consultation in our country. There is great variability of conduct regarding its treatment. The main objective of this work is to analyze the different treatments and their indications.

Materials:

A systematic review of the literature was carried out in the Pubmed and Scielo databases. Articles with fractures due to gunshot wounds in the upper and lower limbs (excluding the hand) were included. We analyzed: treatment (orthopedic or surgical), debridement, antibiotic therapy and complications.

Results:

19 articles were obtained that met the inclusion and exclusion criteria. The articles had a Level of Evidence type 2b, 3 and 4.

Conclusions:

The articles analyzed have a low level of evidence. Surgical fixation is variable and depends on bone topography, soft tissue injury, and associated injuries. Deep debridement is associated with higher rates of infection. Stable orthopedically treated fractures should not be debrided as this increases infection rates. Initial intravenous antibiotic therapy should be performed in all patients, subsequent therapy is discussed.

Palabras clave : fracture; gunshot; firearm; debridement.

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