The Impact of Gunshot Wounds on an Orthopaedic Surgical Service in an Urban Trauma Center

Objective: To determine the prevalence of gunshot wound related orthopaedic injuries in an urban trauma center and outline the socioeconomic background of this patient population. Design: Retrospective study conducted from January 1, 1994, through December 30, 1994. Setting: University-affiliated level 1 trauma center. Patients: Strict inclusion and exclusion criteria were established. Inclusion Criteria: All patients were admitted through the emergency room with a gunshot wound for which the orthopaedic surgery service was consulted. The study group consisted of 284 patients. Exclusion Criteria: Those individuals excluded from the study were patients with an orthopaedic injury who died during or before attempts at resuscitation in the emergency room and patients treated on an outpatient basis. Main Outcome Measures: Orthopaedic and nonorthopaedic diagnoses, etiology, procedures performed, number of hours from admission to the first surgical procedure, average daily hospital census, drug and alcohol screen results, and patient financial status. Results: The orthopaedic service was consulted on 284 patients admitted with gunshot wounds. This group comprised 24% of all orthopaedic admissions, 33% of the average daily orthopaedic census, and 14% of all orthopaedic surgery cases performed. Ninety-four percent were African American and 87% were male, with a mean age of 27 years. Approximately half were tested for alcohol and/or drugs, 45% of whom were positive for alcohol and 65% for drugs. Only 4% of the patients were privately insured. Conclusions: During the period of this study, gunshot wound injuries required more orthopaedic trauma resources than any other single diagnosis.