Outpatient management of low-velocity gunshot-induced fractures

Orthopedics. 2001 Oct;24(10):951-4. doi: 10.3928/0147-7447-20011001-14.

Abstract

This prospective study evaluated the efficacy of an outpatient management protocol for patients with a gunshot-induced fracture with a stable, nonoperative configuration. Forty-one patients (44 fractures) with a grade I or II open, nonoperative fracture secondary to a low-velocity missile comprised the study population. Patients were treated by a standard protocol, which included 1 g of cefazolin administered in the emergency room and a 7-day course of oral cephalexin. Follow-up visits were performed until complete wound and fracture healing were achieved. Thirty-two (78%) of 41 patients underwent full follow-up. Average follow-up was 5.2 months. One (2.8%) fracture (distal fibula) developed a superficial infection, which responded to an additional week of oral antibiotics, and no patient developed a deep infection. There was 1 delayed union and 2 patients with painful retained shrapnel. These results demonstrate that patients with stable, low-velocity, gunshot-induced fractures can be managed effectively and safely on an outpatient basis using this protocol.

MeSH terms

  • Adult
  • Aged
  • Cefazolin / therapeutic use
  • Cephalexin / therapeutic use
  • Cephalosporins / therapeutic use
  • Child
  • Female
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / etiology
  • Fractures, Bone / therapy*
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Retrospective Studies
  • Wounds, Gunshot / complications
  • Wounds, Gunshot / diagnostic imaging
  • Wounds, Gunshot / therapy*

Substances

  • Cephalosporins
  • Cefazolin
  • Cephalexin