Humeral fracture secondary to civilian gunshot injury

Violence is the leading cause of death in the USA. The cost of violence due to gunshot wound is about $425 billion. While the closed fracture of the humerus is common, humeral shaft fractures caused by gunshot wound occur infrequently. There is much controversy regarding their management, i.e. should these injuries be treated surgically or can they be safely treated with minimal intervention. The aim of this study is to review our experience in the management of fourteen patients with a humeral fracture due to gunshot wounds. Of fourteen, seven patients were treated with local debridement, oral antibiotics and fracture brace. The remaining seven patients underwent surgical stabilization of the fracture. The time to union was similar in both groups (6 weeks in non-operative to 9 weeks in open treatment). In conclusion, fracture of the humeral shaft secondary to low velocity gunshot wound in the civilian setting can safely be treated as a closed fracture with local wound care and oral antibiotics.