Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Iowa Orthop J. 2022 Jun;42(1):97-101.
To highlight the unique spectrum of lower extremity firearm injuries seen at a rural, Midwestern level 1 trauma center to provide insight into prevalence, mechanism of injury, and identify modifiable factors that contribute to firearm injuries of the lower extremity. It is our belief that the creation of our database will help future trauma and firearm databases improve documentation and understand the relationship between anatomic location of injury and outcomes.
A retrospective review of lower extremity firearm injuries from a rural, Midwestern level 1 trauma center was collected from January 2011 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.
69 patients with lower extremity firearm injuries were identified. Average age was 30.14 years, 89.86% were males, and one fatality were identified. 47.83% (33) of these injuries were assaults, followed by unintentional injuries at 42.03% (29). Law enforcement-related and self-inflicted injuries contributed minimally. Handguns were the most common type of firearm, used in 72.5% of cases. Nearly 1/3 of the unintentional firearm injuries occurred during November or December, the active deer hunting months in the community of study.
The lower extremity is uniquely vulnerable to both assaults and unintentional injury in our rural environment, differing from what we have previously published regarding the upper extremity. Lower extremity gunshot wounds increased during the winter months, offering a correlation to deer hunting season. Our findings display that not all firearm injuries are created equal, and that there is a need to improve documentation of and additional study in order to optimally tailor firearm prevention measures based on the ruralityurbanicity spectrum. .
强调在农村中西部一级创伤中心看到的下肢火器伤的独特范围，以了解普遍性、损伤机制，并确定导致下肢火器伤的可改变因素。我们相信，创建我们的数据库将有助于未来的创伤和火器数据库改进文档记录，并了解损伤部位与结局之间的关系。
对 2011 年 1 月至 2019 年 12 月期间在农村中西部一级创伤中心的下肢火器伤进行回顾性分析。收集的数据包括损伤描述、人口统计学信息、损伤机制/描述/部位、使用的枪支、毒理学以及有关住院的信息。使用卡方检验和 Fisher 确切检验进行分类数据分析，使用 Wilcoxon 秩和检验进行连续数据分析。
共确定了 69 例下肢火器伤患者。平均年龄为 30.14 岁，89.86%为男性，1 例死亡。这些损伤中 47.83%（33 例）为攻击伤，其次是 42.03%（29 例）的非故意伤害。与执法相关和自残的损伤比例较小。最常见的枪支类型是手枪，占 72.5%的病例。近三分之一的非故意火器伤发生在 11 月或 12 月，即研究社区的活跃狩猎鹿的月份。
在我们的农村环境中，下肢特别容易受到攻击和非故意伤害，与我们之前发表的上肢火器伤不同。下肢枪伤在冬季月份增加，与鹿狩猎季节相关。我们的发现表明，并非所有火器伤都是平等的，需要改进文档记录并进行更多研究，以便根据城乡范围优化针对火器伤的预防措施。
