Gunshot Fractures Of The Extremities In A Community Clash: The Experience Of Two Teaching Hospitals In Nigeria
Keywords:casualty, mortality, complication
Background: Civil strife often leads to large numbers of patients with severe injuries. The gunshot injuries sustained in the communal clash between the Ifes and Modakekes in Nigeria were the subjects of this study.
Method: The history was recorded for each patient presenting at the hospital with gunshot injuries from the clash. Each patient was examined and followed up through subsequent treatment in the wards and clinics. The period of follow-up was two years.
Results: Ninety-seven (52.4%) of the 185 patients who had gunshot injuries sustained fractures over a two-month period, but 90 of these attended follow-up till the final assessment. The femur (28 patients) followed by the tibia and fibula (21) were most commonly fractured. Nine (10%) were Gustillo Anderson grade II, 42 (46.7%) were grade IIIA, 26 (28.9%) grade IIIB and 7 (7.8%) grade IIIC open fractures. The primary surgical treatment was debridement and fracture stabilization 84 (93.3%) and 6 (6.7%) had amputation. Seventy three (81.9%) had repeat surgeries. The initial complication rate (1.5 per patient) was high but most of the complications resolved leaving 15 (16.7%) with permanent disability. No mortality was recorded.
Conclusion: There is need to improve the preparedness and alertness of hospitals for mass casualty