Background: Gunshot injuries frequently involve the foot and ankle. The standard of care for treatment of gunshot injuries to the foot and ankle is not clear. To better understand these injuries, we completed a retrospective review of foot and ankle gunshot injuries at a level-1 trauma center seen as orthopaedic consults over a 2-year period. Methods: Orthopaedic consults for foot and ankle gunshot injuries from June 1st, 2018, through May 31st, 2020, were reviewed. Patient characteristics, zone of injury, mechanism of injury, associated injuries, treatment, follow-up, and outcomes were recorded. Results: Forty-eight foot and ankle gunshot injuries were identified, encompassing 16.0% of all gunshot consults in that period. Most patients were men and, on average, 30 years old. Most injuries were due to altercations and self-inflicted injuries. Most injuries were distal to the tarsometatarsal joint (zone one). There were three arterial injuries, five nerve injuries, and one tendon laceration. Three infections occurred, and 18 patients did not follow-up after their initial consultation. Most patients (68.8%) were treated as outpatients with a dose of intravenous antibiotics, bedside irrigation and debridement, and immobilization followed by a short course of oral antibiotics. Conclusion: In this series, most gunshot injuries to the foot and ankle occurred in men approximately 30 years of age owing to altercations. Most were treated nonoperatively with a 6.0% rate of infection. From our review, nonoperative treatment was found to be successful in the majority of gunshot injuries to the foot and ankle.
Imada, Allicia O.; Jory Wasserburger; Aamir N. Ahmad; and Katherine Gavin. "Gunshot Wounds to the Foot and Ankle: Review of Cases from a Level-1 Trauma Center." Western Journal of Orthopaedics 10, 1 (2021). https://digitalrepository.unm.edu/wjo/vol10/iss1/7