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Tratamiento de lesiones traumáticas de las manos producidas por armas de fuego

Keywords: firearms wounds, traumatic lesions, hand, treatment.

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Abstract:

introduction. the wounds caused by firearms in hands may to affect significantly their functions, thus, it is important that the first treatment be the appropriate. although the hand's lesions caused by firearms are infrequent in our environment, the objective of present paper was to demonstrate our experience in this respect. methods. a longitudinal and prospective study was conducted in 10 patients presenting with hands's lesions caused by firearms seen in the sana's general military hospital (yemen) from january to october, 2009. all patients had fractures in some of the hand's bones: metacarpal(8) and phalanx (2). nervous lesions (7) were located in the motor branch of median nerve (2) and in the finger's sensitive branches (5). nine of the 10 patients had tendinous lesions in the extensor and flexor ones (5) and in the extensors only (4). results. all fractures welded: eight in a primary way and two of them requiring bone graft. complications included dry gangrene in one finger with a necessary amputation of that ray as well as a proximal interphalangeal stiffness in two patients. conclusions. although the hand's lesions caused by firearms are complex, when they are appropriately treated from the first moment using a suitable lavage and debridement, fracture's fixation, wound closure when be necessary, appropriate immobilization, pain and inflammation treatment and early rehabilitation, complications decrease achieving good functional results.

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