Fractures of the femur secondary to low-velocity gunshot wounds.

Forty-three fractures of the shaft of the femur secondary to low-velocity gunshot wounds were evaluated to determine healing time, fracture alignment after healing, complications, and fracture characteristics. This study confirmed the previous reports of low infection rates and the need for minimal debridement for such fractures. The healing time was faster than that of closed fractures treated by similar means: the average healing time was 144.3 days. Alignment was easy to obtain and maintain, the average angular deformity being 5 degree or less with no rotational deformities. Three characteristic fracture types were noted: the double butterfly configuration of the shaft of the femur, the drill-hole fracture of the distal third of the femur as previously described experimentally, and a third type of fracture with an incomplete fracture secondary to the gunshot wound which acted as a stress riser with a resultant spiral fracture either proximal or distal to the impact site.