In the line of fire--21st-century approach to an ancient war injury.

Authentic black-powder muzzle-loader weapons or replicas are used today primarily for re-enactments of historic battles. A lay actor playing the role of a Prussian infantryman sustained life-threatening gunshot injuries during a recent re-enactment of a historic battle of the Sixth Coalition. As only blank historic muzzle-loading weaponry was used, the origin of the missile causing the wounding was initially unclear. Further investigation revealed a ramrod that had been propelled out of the barrel of another gunner's smooth-bore gun as cause of injury. The ramrod was hurled on a trajectory of more than 20 m, breaking the victim's shouldered barrel and hitting the victim resulting in severe abdominal, thoracic, and upper limb injuries. The critical incidents while handling muzzle-loading weaponry leading to premature discharge are elucidated. Furthermore, this report demonstrates how actual diagnostics and subsequent surgical treatment enabled this infantryman to survive an injury to which his comrades-in-arms would have succumbed 200 years ago.