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Abstract Background South Africa has one of the highest gun related mortality in the world - 20 people per day. The available data however do not reflect the substantial number of patients suffering non-lethal firearm injuries. Gunshot related injury has been recognised as a highly costly healthcare problem by individual treating centres in South Africa and other countries, however no ‘national picture’ has been examined in detail. Objectives This study sought to explore the burden of gunshot related orthopaedic injuries across South Africa. Method A multicentre research network was established across South Africa and 37 orthopaedic units across nine provinces participated. A prospective, observational cohort study was performed during a two-week period in 2019. Cases were screened, enrolled and reported by the local orthopaedic teams. Patients were included if they had at least one acute gunshot related orthopaedic fracture referred to the orthopaedic service. Patients were asked additional questions around baseline health-related quality of life (HRQOL) and personal circumstances. Follow up was at 8 weeks following the injury. Results Thirty-seven centres enrolled 135 patients over the two-week study period. The Western Cape had the highest number of reported cases 52 (39%), followed by Gauteng (35, 26%) and KwaZulu-Natal (29, 21%). The median age of patients was 30.5 years and the majority were male (89%). Forty three percent of patients had been either shot or stabbed previously, prior to this injury. Fifty-two percent of all cases required fracture fixation surgery and 11% of cases required wound debridement without fracture fixation. HRQOL data were collected successfully at baseline, but fewer than 25% of cases had follow up data. Conclusion Gunshot-related orthopaedic injuries represent a significant burden of disease in the South African healthcare environment. This study highlights several areas for further research in both the management of the injuries and associated outcomes.

Type

Journal article

Journal

Samj south african medical journal

Publisher

Health and Medical Publishing Group

Publication Date

16/09/2020