Low-energy handguns can contribute to infection and compartment syndrome

Orthopaedic surgeons should pay close attention to handgun injuries

Gunshot injuries are typically categorized as low- or high-energy based on the weapon's missile velocity and mass. Typically, low energy injuries are treated with simple wound care, with or without antibiotics, regardless of the presence of a fracture. In contrast, high energy injuries are treated more aggressively.

A new study, "Handgun Injuries in 2012: What the Orthopaedic Surgeon Needs to Know," presented today at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), found that modern low-energy handgun ammunition is designed to inflict significant soft tissue damage, which can cause infection and compartment syndrome (a painful condition that occurs when pressure within the muscles builds to dangerous levels). A review of ballistics data from forensic scientists and law enforcement officers in a major U.S. city police department, as well as gunshot-induced fractures from a single level 1 trauma center, found that low-energy handgun injuries have become more prevalent, and with hollow point ammunition (designed to expand when entering the body), can cause severe underlying tissue injury that may be overlooked by clinicians.

According to the study authors, orthopaedic surgeons need to be aware of this powerful new ammunition, and the likelihood that even "low energy" handguns can cause substantial bone and soft tissue injury.

Source: American Academy of Orthopaedic Surgeons