上肢火器伤的农村特点。

The Rurality of Upper Extremity Firearm Injuries.

机构信息

Department of Orthopedics, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.

出版信息

Iowa Orthop J. 2021;41(1):171-176.

PMID:34552421

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8259192/

Abstract

BACKGROUND

To highlight the unique spectrum of hand and upper extremity firearm injuries seen at a rural, Midwestern level 1 trauma center and identify modifiable factors that contribute to firearm injuries of the hand and upper extremity.

METHODS

A retrospective review of upper extremity firearm injuries from a rural, Midwestern level 1 trauma center was collected from January 2002 to December 2019. Data acquired included injury description, demographics, injury mechanism/description/location, firearm used, toxicology, and information regarding hospitalization. Data was analyzed using Chi-squared analysis and Fisher's exact test for categorical data and the Wilcoxon rank sum test for continuous data.

RESULTS

55 patients with upper extremity firearm injuries were identified. Average age was 33.3 ± 13.0 years, 81.8% were males, and zero fatalities were identified. 58% (38) of these injuries were unintentional firearm injuries, followed by assaults at 34.6% (19). Law enforcement-related and self-inflicted injuries contributed minimally. Handguns were the most common type of firearm, used in 43.6% of cases. 7.3% (4) of injuries occurred while hunting, with 21.8% (12) total during November or December, the active deer hunting months. 92.7% (51) of all firearm injuries presented with fracture, among which 92.2% (47) met a Gustilo-Anderson classification score of at least 3A. Alcohol was detected in 20% (11) of the patients, while other drugs of abuse were detected in 36.4% (20).

CONCLUSION

Our data suggests that upper extremity firearm injuries in a rural population are unique from urban injuries in that they are predominately unintentional, isolated, and non-fatal. We identify a distinct rural cohort that may benefit from better directed interventions to prevent firearm injuries and ultimately guide firearm education and public policy..

摘要

背景

突出在农村中西部一级创伤中心所见手部和上肢火器伤的独特范围，并确定导致手部和上肢火器伤的可改变因素。

方法

对 2002 年 1 月至 2019 年 12 月期间，农村中西部一级创伤中心上肢火器伤进行回顾性研究。收集的数据包括损伤描述、人口统计学、损伤机制/描述/部位、使用的枪支、毒理学以及住院相关信息。采用卡方检验和 Fisher 确切概率法对分类数据进行分析，对连续数据采用 Wilcoxon 秩和检验进行分析。

结果

共确定 55 例上肢火器伤患者，平均年龄为 33.3±13.0 岁，81.8%为男性，未发生死亡。58%（38 例）为非故意性火器伤，其次是 34.6%（19 例）的袭击伤。执法相关和自残伤所占比例较小。手枪是最常见的枪支类型，占 43.6%。有 7.3%（4 例）的损伤发生在狩猎时，有 21.8%（12 例）总发生在 11 月或 12 月，即活跃的猎鹿月份。92.7%（51 例）的所有火器伤均伴有骨折，其中 92.2%（47 例）符合 Gustilo-Anderson 分级评分至少 3A。在 20%（11 例）的患者中检测到酒精，在 36.4%（20 例）的患者中检测到其他滥用药物。