TITLE:
Leg Injuries by Firearms in Kisangani: Epidemiological, Clinical, Ballistic and Anatomopathological Aspects
AUTHORS:
Ralph Munsense Tshiyombo, Felly Kanyinda Ciamala, Asaph Bwini Dianaben, Aimé Lukwamirwe Vahamwiti, Judith Ngoy Safi, Urbain Amini Kangali, Flavien Adipepe Bekale, Jean-Marie Vianney Tshimbila Kabangu
KEYWORDS:
Leg Injuries, Firearms, Ballistics, Anatomopathology
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.13 No.3,
March
12,
2025
ABSTRACT: Context: This article presents leg injuries caused by firearms in their epidemiological, clinical, ballistic and anatomopathological aspects. Leg injuries from firearms are no longer the preserve of war. Indeed today, they are frequently found in civil practice affecting the most disadvantaged social classes, who pay the heaviest price. The objective of this work was to identify the epidemiological, clinical, ballistic and anatomopathological aspects of traumatic leg injuries caused by firearms in Kisangani. Methods: This is a retrospective study carried out in 6 reference hospitals in Kisangani: The University Clinics of Kisangani, the General Reference Hospitals of Kabondo, Lubunga, Makiso as well as the Military Hospital of the 3rd zone of defense and the reference military health center of the Lokosa training center. The sample consisted of 117 injured people with documented firearm leg injuries. Our data collection technique is a documentary analysis based on patient medical files, consultation registers, operating, anesthesia and hospitalization reports from the departments. These data were entered with Excel 2013 then imported to IBM SPSS version 20 for analysis. Results: From January 2019 to December 2023, we recorded 3572 trauma patients, among whom 308 patients had ballistic trauma, i.e. a hospital frequency of 8.62% of cases and 117 cases of ballistic leg trauma, i.e. 37.99%. With a male predominance (76%), i.e. a sex ratio of 3/1 in favor of the male sex. The age group of 22 to 32 was the most common in 49.57% of cases. The average age of our injured was 29.88 years with a standard deviation of 12.28 and extremes minimum 7 years and maximum 78 years. Pupils and students were the majority (29.06%). The majority of injured people (71.79%) had lesions with entry and exit orifices without a retained projectile. 66.67% of injured people were hemodynamically stable. The left leg was the most affected (47.86%). Of all these injuries, 58.12% were open fractures. The majority of fractures are complex (69.57%). Fractures of the bones of the leg concerned more than a third proximal (55.07%). Most of these fractures (44.93%) are type IIIB according to the GUSTILO and ANDERSON classification. The majority of leg lesions (52.14%) were isolated without any lesion association. Conclusion: Leg injuries from firearms pose a serious public health problem and constitute a daily and alarming concern in developing countries due to their increasingly frequent occurrence, their high cost of care and complications, disabling effects that they cause. Therefore, as for war doctors, the diagnosis and treatment of these injuries must be mastered by all healthcare personnel working in civilian practice.