Severe Vascular Gunshot Injuries of the Extremities: A Ten-Year Nation-Wide Analysis from Finland

Abstract

Background and Aims: Gunshot wounds affecting the main vessels of the extremities mostly threaten limb salvage. The purpose of this study was to analyse the nature and severity of civilian vascular gunshot injuries of the extremities using a nation-wide database. Material and Methods: Retrospective analysis of the Finnish Hospital Discharge Register, hospital records and death certificates over a 10-year period from January 1, 1990 to December 31, 1999. Results: Thirty-two individuals with the mean age of 33 years (17–68) sustained 43 severe vascular injuries to the extremities caused by gunshots. The incidence was 6.0 (95% CI: 4.1–8.5) per 10, 000, 000 person-years and did not change significantly during the period. Four of the injured died. The most common anatomical locations of vascular injuries were the femoral artery (6 lesions), popliteal artery (6) and superficial femoral artery (5). Use of alcohol was detected in ten cases (32% of patients) and of illegal drugs in seven cases (22%). Five patients (18% of non-fatal injuries) required vascular re-operation caused by post-operative problems. Five amputations were performed as primary treatment. Conclusions: Severe vascular gunshot injuries of the extremities are not common in Finland. The need for primary amputation or vascular re-operations is noteworthy.