Colen Alexander J, Hanson Logan F, Frits Germaine R, Hanson Cameron G
Beaumont Health Orthopedic Resident, PGY 4, Farmington Hills, MI.
Beaumont Health Orthopedic Resident, PGY 5, Farmington Hills, M.
Spartan Med Res J. 2017 Aug 24;2(1):6345. doi: 10.51894/001c.6345.
Sidearm pistols are more frequently involved in violent crimes due to their relatively small size and ability to be concealed. The extent to which the thermal energy released from such medium velocity pistol projectiles contributes to peripheral nerve injury requires further testing. The purpose of this paper is to describe a method to quantify how much thermal energy is released during impact of medium velocity pistol projectiles and report how thermal energy contributes to peripheral nerve injury.
Eleven seven-centimeter segments of radial, median, and ulnar nerves were dissected from a thawed fresh frozen cadaver. The nerve segments were placed in a 10% ballistics gel block, one centimeter from the end of the block nearest the shooter. A series of 115-grain 9 mm. NATO-classified ammunitions were fired through the nerve and ballistics gel construct with a pistol. The impacts were recorded with a high-speed infrared camera and nerve samples were sent for histologic analysis by two board-certified pathologists.
The average velocity of the projectiles were 391m/s, 95% CI [387-395 m/s], with an average kinetic energy of 572.0 J, 95% CI [560.0-583.0J]. The average observable temperature of the ballistics gel/nerve prior to impact was 28.8°C±0.6ºC, 95% CI [26.4-30.3°C]. Average observable temperature of the surrounding ballistics gel/nerve during projectile impact was 55.1°C±2.4ºC, 95% CI [51.3- 62.1°C], yielding an average observable increase of 26.4°C±3.2ºC, 95% CI [20.2- 35.4°C]. An adjusted temperature increase was also surprisingly high 63.4°C ± 3.2, 95% CI [57.2 - 72.4ºC]. Histology reports of the impacted nerve tissue failed to show any sign of thermal or even crush injury.
Medium velocity handgun projectiles release a significant amount of heat energy when impacting a substance similar to human tissue. The authors' temperature data points were greater than those previously reported to cause thermal injury to peripheral nerves. The authors' findings suggest that nerve injury after collision with pistol projectiles may be secondary to thermal injury in addition to the classic model of concussion and penetration given our documented levels of heat generated during impact.
由于袖珍手枪尺寸相对较小且易于隐藏,其在暴力犯罪中更为常见。中等速度手枪发射的子弹释放的热能对周围神经损伤的影响程度尚需进一步研究。本文旨在描述一种方法,用于量化中等速度手枪子弹撞击时释放的热能,并报告热能对周围神经损伤的影响。
从一具解冻的新鲜冷冻尸体上解剖出11段7厘米长的桡神经、正中神经和尺神经。将神经段置于一个10%的弹道凝胶块中,距离凝胶块最靠近射击者的一端1厘米。使用手枪向神经和弹道凝胶结构发射一系列115格令的9毫米北约标准弹药。用高速红外摄像机记录撞击过程,并将神经样本送交两位具备专业资格认证的病理学家进行组织学分析。
子弹的平均速度为391米/秒,95%置信区间为[387 - 395米/秒],平均动能为572.0焦耳,95%置信区间为[560.0 - 583.0焦耳]。撞击前弹道凝胶/神经的平均可观测温度为28.8°C±0.6°C,95%置信区间为[26.4 - 30.3°C]。子弹撞击过程中周围弹道凝胶/神经的平均可观测温度为55.1°C±2.4°C,95%置信区间为[51.3 - 62.1°C],平均可观测温度升高了26.4°C±3.2°C,95%置信区间为[20.2 - 35.4°C]。经调整后的温度升高也出奇地高,为63.4°C ± 3.2,95%置信区间为[57.2 - 72.4°C]。受撞击神经组织的组织学报告未显示任何热损伤甚至挤压伤的迹象。
中等速度手枪子弹撞击类似人体组织的物质时会释放大量热能。作者记录的温度数据高于先前报道的可导致周围神经热损伤的温度。作者的研究结果表明,鉴于撞击过程中产生的热量水平,手枪子弹撞击后神经损伤可能除了经典的震荡和穿透模型外,还继发于热损伤。