J Korean Fract Soc.  2017 Apr;30(2):83-88. 10.12671/jkfs.2017.30.2.83.

Fracture of the Humeral Shaft Secondary to High-Velocity Gunshot (Machine Gun) Injury: A Case Report

• Lee KW
• Bae JY
• Lee SK

• KMID: 2376614
• DOI: http://doi.org/10.12671/jkfs.2017.30.2.83

Abstract

High-velocity gunshot injury (muzzle velocity greater than 609.6 m/s) is uncommon and primarily a military injury. Humerus shaft fracture, caused by a high-velocity gunshot, should be considered as a severe open fracture. The principles of treatment are immediate and aggressive irrigation, wide debridement, primary delayed wound closure, and broad-spectrum intravenous antibiotics. External fixation has been widely used for fracture fixation. We report a case of humerus shaft fracture secondary to high-velocity gunshot (machine gun) injury, with a literature review.

Keyword

Humerus; Fracture; Gunshot wound

MeSH Terms

Anti-Bacterial Agents
Debridement
Fracture Fixation
Fractures, Open
Humans
Humerus
Military Personnel
Wounds and Injuries
Wounds, Gunshot
Anti-Bacterial Agents

Figure

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  Fig. 1 Exit wound of the right arm exhibits massive tissue and bone destruction—a characteristic of M-60 gunshot wound in which the bone is hit by M-60 bullets.

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  Fig. 2 (A) Initial radiograph shows comminuted humeral shaft fracture and multiple foreign bodies. (B) Initial computed tomography angiography scan.

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  Fig. 3 Photograph of radial nerve (arrow) injury.

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  Fig. 4 (A) Photograph of external fixation. (B) Radiograph after the removal of the bone and bullet fragments with external fixation.

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  Fig. 5 Photograph after anterior (A) and posterior (B) wound closure.

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  Fig. 6 (A) Intraoperative photograph shows open reduction and internal fixation with plate and screw, as well as autologous rib graft. (B) Postoperative radiograph shows open reduction and internal fixation with plate and screw, as well as autologous rib graft.

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  Fig. 7 Photograph of elbow and hand movement.

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  Fig. 8 Radiograph after implant removal.

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