TITLE:
Simultaneous, Asymmetrical, Comminuted and Bilateral Ballistic Fractures by Multiple Gunshot Wounds and a Review of Its Literature: A Case Report in Chad
AUTHORS:
Siniki Fandebnet, Ngamai Kotyade, Adamou Abbasi, Dingamnodji Magloire, Mahamat Bahar Abdelsalam, Yusra Aboulbachar, Assi Constant, Andre Daniel Sane
KEYWORDS:
Simultaneous Bilateral Tibia-Fibula Fractures, Gunshot Wounds, External Fixator, Ballistic Fractures
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.12 No.10,
October
13,
2022
ABSTRACT: Although open leg fractures are very common in orthopedics and traumatology, bilateral open leg fractures are extremely rare and are usually associated with an increased risk of complications. We report a case of a simultaneous, asymmetrical, comminuted and bilateral open fracture of the tibia and fibula by a firearm that occurred during an escape attempt in a 29-year-old prisoner. The pre-operative radiological assessment found an open fracture of both legs of the ballistic type; multiple traumatic gunshot wounds with a narrow entry hole and a wide exit hole. Early surgical intervention of intravenous antibiotics, tetanus prophylaxis and open fracture irrigation and debridement was performed within the 6 hour rule. The treatment consisted of a posterior splint followed by trimming andosteosynthesis using a FESSA external fixator from the military health service. A second operation was not needed. Evolution was favorable with ambulation starting from the 45th day. Simultaneous and bilateral tibia-fibula fractures by a firearm are exceptional, therefore, the treatment was surgical with the pre-operative and post-operative protocols well managed.