Civilian gunshot victim with low-energy bullet injuries to lower extremities and atypical left distal femur fracture: a case report

Abstract

This case report details the management of low-velocity gunshot wounds (GSWs) in a 28-year-old man, emphasizing the distinctive challenges and treatment strategies in urban civilian settings. This study contributes to medical literature by providing insights into the complexities of treating atypical fractures caused by GSWs, especially involving nonstandard ammunition. The patient, involved in an urban gunfight, sustained multiple low-velocity GSWs to his lower limbs. The diagnoses included an atypical intra-articular fracture in the left distal femur and a foreign body in the right lower leg. Treatment involved emergency surgery with K-wire stabilization for the left femur fracture and exploratory surgery for the right leg. No foreign bodies were found in the right leg, but subsequent analysis revealed pseudo-encapsulated calcification, indicative of previous fat necrosis. In 15 days after the initial trauma, the final surgical intervention took place, during which a low-contact condylar plate was placed on the left distal femur. Postoperative recovery was successful, with the patient regaining full mobility and range of motion after one year. Low-velocity GSWs in civilian settings can result in complex atypical fractures requiring specialized surgical intervention and management.

Keywords

• Case report
• Distal femoral fracture
• Gunshot wounds
• Intra-articular fractures
• Low-velocity trauma
• Surgical fixation techniques