Simultaneous, Asymmetrical, Comminuted and Bilateral Ballistic Fractures by Multiple Gunshot Wounds and a Review of Its Literature: A Case Report in Chad

作     者：Siniki Fandebnet Ngamai Kotyade Adamou Abbasi Dingamnodji Magloire Mahamat Bahar Abdelsalam Yusra Aboulbachar Assi Constant Andre Daniel Sane Siniki Fandebnet;Ngamai Kotyade;Adamou Abbasi;Dingamnodji Magloire;Mahamat Bahar Abdelsalam;Yusra Aboulbachar;Assi Constant;Andre Daniel Sane

作者机构：Department of Orthopaedics and Traumatology Renaissance University Hospital N’Djamena Chad Department of Anesthesia Renaissance University Hospital N’Djamena Chad Department of Accident and Emergency Renaissance University Hospital N’Djamena Chad Department of Medicine Renaissance University Hospital N’Djamena Chad Department of Cardiology Renaissance University Hospital N’Djamena Chad Department of Surgery Cheik Anta Diop University Dakar Senegal 

出 版 物：《Open Journal of Orthopedics》 (矫形学期刊（英文）)

年 卷 期：2022年第12卷第10期

页      面：377-382页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Simultaneous Bilateral Tibia-Fibula Fractures Gunshot Wounds External Fixator Ballistic Fractures 

摘      要：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.