Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota.
Department of Orthopaedic Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
J Bone Joint Surg Am. 2021 Jun 2;103(11):1026-1037. doi: 10.2106/JBJS.20.01544.
➤: Despite an increasing rate of civilian low-velocity gunshot injuries, there remains a lack of evidence-based treatment standards.
➤: Most low-velocity gunshot-induced fractures of the extremity can be managed similarly to non-gunshot-induced fractures, with the goals of restoring function and minimizing complications.
➤: There are a limited number of high-quality studies to support the use of prophylactic antibiotics for nonoperatively treated gunshot wounds.
➤: Intra-articular retained bullets should be removed, while prophylactic irrigation and debridement for a transarticular bullet is not routinely warranted for infection prevention.
➤: Much of the literature on low-velocity gunshot wounds is Level-III or IV evidence, warranting the need for higher-powered, randomized, prospective investigations.
➤：尽管民用低速射弹伤的发生率不断增加，但仍缺乏循证治疗标准。
➤：大多数四肢低速射弹所致骨折可采用与非射弹所致骨折相似的方法进行治疗，其治疗目标是恢复功能和尽量减少并发症。
➤：支持预防性使用抗生素治疗非手术治疗的射弹伤的高质量研究数量有限。
➤：关节内遗留的子弹应予以取出，而对于关节内子弹，预防性灌洗和清创术并不能常规预防感染。
➤：关于低速射弹伤的大部分文献为 III 级或 IV 级证据，这需要进行更强大、随机、前瞻性的研究。
