Ganocy K, Lindsey R W
Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX.
Injury. 1998;29 Suppl 1:SA1-6.
The incidence of intra-articular low-velocity gunshot wounds is increasing as the number of civilians injured by handguns grows. The severity of these injuries can vary and the general principles of managing them, particularly in regards to the role of irrigation, debridement and prophylactic antibiotics, are evolving. The authors suggest that injuries can be classified according to the ultimate location of the projectile, the level of contamination, and the type of fracture present. Injuries in which the projectile has no contact with the synovial fluid, with a low level of contamination, and a stable fracture pattern may be treated non-operatively, with antibiotics only. Wounds in which the bullet remains in contact with synovial fluid have a higher level of contamination or have a fracture requiring internal fixation and intravenous antibiotics in combination with more aggressive surgical treatment.
随着手枪致伤平民数量的增加，关节内低速枪伤的发生率也在上升。这些损伤的严重程度各不相同，其处理的一般原则，尤其是在冲洗、清创和预防性抗生素的作用方面，正在不断演变。作者建议，损伤可根据子弹的最终位置、污染程度和骨折类型进行分类。子弹未与滑液接触、污染程度低且骨折模式稳定的损伤，可仅用抗生素进行非手术治疗。子弹仍与滑液接触、污染程度较高或有需要内固定的骨折，以及静脉使用抗生素并结合更积极的手术治疗的伤口。
