@article{ref1,
title="The rurality of upper extremity firearm injuries",
journal="Iowa orthopaedic journal",
year="2021",
author="McIlrath, Matthew D. and Fleury, Ignacio G. and An, Qiang and Buckwalter, Joseph A.",
volume="41",
number="1",
pages="171-176",
abstract="BACKGROUND: To highlight the unique spectrum of hand and upper extremity firearm injuries seen at a rural, Midwestern level 1 trauma center and identify modifiable factors that contribute to firearm injuries of the hand and upper extremity. <br><br>METHODS: A retrospective review of upper extremity firearm injuries from a rural, Midwestern level 1 trauma center was collected from January 2002 to December 2019. Data acquired included injury description, demographics, injury mechanism/description/location, firearm used, toxicology, and information regarding hospitalization. Data was analyzed using Chi-squared analysis and Fisher's exact test for categorical data and the Wilcoxon rank sum test for continuous data. <br><br>RESULTS: 55 patients with upper extremity firearm injuries were identified. Average age was 33.3 ± 13.0 years, 81.8% were males, and zero fatalities were identified. 58% (38) of these injuries were unintentional firearm injuries, followed by assaults at 34.6% (19). Law enforcement-related and self-inflicted injuries contributed minimally. Handguns were the most common type of firearm, used in 43.6% of cases. 7.3% (4) of injuries occurred while hunting, with 21.8% (12) total during November or December, the active deer hunting months. 92.7% (51) of all firearm injuries presented with fracture, among which 92.2% (47) met a Gustilo-Anderson classification score of at least 3A. Alcohol was detected in 20% (11) of the patients, while other drugs of abuse were detected in 36.4% (20). <br><br>CONCLUSION: Our data suggests that upper extremity firearm injuries in a rural population are unique from urban injuries in that they are predominately unintentional, isolated, and non-fatal. We identify a distinct rural cohort that may benefit from better directed interventions to prevent firearm injuries and ultimately guide firearm education and public policy.Level of Evidence: III.<p /> <p>Language: en</p>",
language="en",
issn="1541-5457",
doi="",
url="http://dx.doi.org/"
}