The phrase, “don’t shoot yourself in the foot”, is a common expression that means to not say or do something that is damaging or careless. However, a 16-year old boy from Chicago made this expression literal when he shot himself in the foot when trying to defend himself from a robber. When the teen was approached by robbers he pulled out his gun, and accidentally fired it, hitting his own foot. The boy was taken to a hospital, and reported to be in good condition.
Gun shot wounds on the lower extremity are not that uncommon, in fact they make up about 5% of all gunshot wounds. Gun shot wounds in the lower extremity are usually not fatal, but still require a lot of care. The anatomy in the lower extremity is complex, and consists of 26 bones, 33 joints, 107 ligaments, 19 muscles, numerous tendons, arteries and nerves all in a small amount of space. Treatment varies greatly depending on the amount of soft tissue, bone, arterial, and nerve damage. First, a radiograph and CT will be taken to identify the location of the bullet if the bullet is still in the foot, and also view the extent of the damage. This type of injury will be treated very similar to an open fracture wound so local wound care, tetanus update, and antibiotics are important. Wound cultures will need to be taken, and antibiotic therapy will be adjusted accordingly. If surgery is indicated and the patient is stable, then open reduction internal fixation or external fixation will be done to correct and stabilize the bones. Often skin grafts are needed when there is extensive soft tissue damage. The end result may not be the best in appearance, but the goal is to retain as much function as possible. In the case of injury to blood supply, then surgery will need to be done urgently to prevent gangrene or loss of the limb. Another urgent situation that may arise is compartment syndrome, and will also require emergency surgery to relieve pressure. Special care must be taken to remove all lead fragments that the bullet may have left behind to prevent lead toxicity.
Gunshot injuries to the lower extremity are very serious even though they are not typically fatal. Management of gunshot wounds can be tricky because of the amount of structures in the foot. Treatment may involve multiple procedures, lots of wound care, and even amputation. The best way to prevent this type of injury is simply; don’t shoot yourself in the foot!
Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.
Columbus Podiatry & Surgery in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.
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