Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, United States.
Vet Comp Orthop Traumatol. 2022 May;35(3):205-212. doi: 10.1055/s-0041-1739238. Epub 2021 Dec 7.
The aim of this study was to summarize outcomes and complications of gunshot fracture management in small animals.
Review of cats and dogs with radiographically confirmed acute gunshot fractures, presenting data on signalment, fracture location, fracture management (surgical non-surgical, type of surgical repair), fracture comminution, extent of soft tissue trauma, postoperative complication and overall outcome. A poor outcome was defined as patient death, major postoperative complication or limb amputation (both as primary treatment or secondary to postoperative complications).
Ninety-seven animals with 137 acute gunshot-induced fractures were identified. There were 21 (15.3%) maxillofacial, 16 (11.7%) vertebral column, 8 (5.8%) rib, 56 (40.9%) distal long bone (below stifle/cubital joint) and 36 (26.3%) proximal long bone (at or above stifle/cubital joint) fractures. Overall, 20/37 cases with sufficient follow-up details incurred a poor fracture outcome. Extensive soft tissue trauma at the fracture site was associated with an increased likelihood of poor outcome. The most common poor outcomes were primary limb amputations (7 cases) and postoperative complications (3 osteomyelitis/surgical site infections, 4 delayed/non-unions).
Gunshot fractures overall have high likelihood of poor outcome. Severe soft tissue injury is associated with complications. Mitigating poor outcome likely requires early aggressive wound management.
本研究旨在总结小动物枪弹骨折管理的结果和并发症。
回顾了影像学证实的急性枪弹骨折的猫和狗，提供了关于年龄、骨折部位、骨折管理（手术或非手术、手术修复类型）、骨折粉碎程度、软组织损伤程度、术后并发症和整体结果的数据。预后不良定义为患者死亡、严重术后并发症或肢体截肢（均作为主要治疗或继发于术后并发症）。
共发现 97 只动物有 137 处急性枪弹所致骨折。其中 21 处为颌面骨折（15.3%），16 处为脊柱骨折（11.7%），8 处为肋骨骨折（5.8%），56 处为远端长骨骨折（膝关节/肘关节以下）（40.9%），36 处为近端长骨骨折（膝关节/肘关节以上）（26.3%）。在有足够随访细节的 37 例中，有 20 例发生了预后不良的骨折。骨折部位广泛的软组织创伤与预后不良的可能性增加相关。最常见的预后不良结果是原发性肢体截肢（7 例）和术后并发症（3 例骨髓炎/手术部位感染，4 例延迟/不愈合）。
总体而言，枪弹骨折预后不良的可能性很高。严重的软组织损伤与并发症相关。改善预后不良可能需要早期积极的伤口管理。
