Patrizio Petrone (Mineola, NY / US), Javier Dagnesses Fonseca (Mineola, NY / US), Jordi Marín García (Mineola, NY / US), John McNelis (Bronx, NY / US), Corrado Marini (Bronx, NY / US)
Introduction. Ballistics is the science that studies the trajectory, range, and effects of projectiles. The principles of wound ballistics (Figures 1-2) are of interest to the surgeon because they allow the optimization of the diagnosis and treatment of patients injured by firearms. The objective of this study is to review the updated information of wound ballistics that may aid in the diagnosis and treatment of gunshot wounds.
Methods. A literature review, limited to observational studies in English and Spanish published between January 2014 amd March 2024 was performed using the PubMed, Scopus, and Embase databases. Studies included for full review included those that described wound ballistics and its relationship with patients" treatment, whereas studies about weapon design, experimental, forensic, historical studies, and reports on pediatric population were excluded.
Results. Eleven articles from 28 publications met the inclusion criteria underwent full review. The most frequent mechanisms of injury included temporary cavitation (indirect damage), permanent cavitation (direct damage), complex fragment cavitation, laceration, microvascular damage, and ischemia propensity to vascular injury depdendent on bullet type.
Conclusions. The principles of wound ballistics are applicable to the diagnosis of potential injuries and treatment of gunshot wounds in adults.
Figure 1. Mechanisms of projectile injury in the formation of the permanent tract and the temporary cavity. (A) Effects of the projectile fired from a pistol or low-velocity firearm. (B) Effects of the inclination of a projectile fired from a military rifle or high-velocity firearm.
Figure 2. Projectile movements. (A) Yawing: Deflection of the projectile in its longitudinal axis. (B) Tumbling: Spinning action beyond 90º forward around the center of mass. (C) Precession: Complex spiral movement of the bullet tip resulting from the gyroscopic stabilizing effect around its center of mass.
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