GUNSHOT WOUNDS OF THE MAJOR JOINTS

¹ Medical Corps, Army of the United States

1. One hundred thirty-four gunshot wounds of the major joints, treated during the North Burma Campaign, have been analyzed.

2. Disability of some degree—due to chronic arthritis, fibrous or bony ankylosis, and associated nerve injury—is relatively common.

3. The most important measure in the treatnment of these injuries is early and thorough débridement. Closure of the capsule, after a thorough débridement, is probably helpful in preventing infection of the joint. If there is any doubt about the adequacy of the débridement or removal of all foreign bodies, the capsule should not be closed.

4. Septic arthritis, which occurred in one-third of these patients, is a serious complication. Early arthrotomy, with radical incisions to provide adequate drainage, will salvage many joints and is preferable to early resection.

5. Chronically infected joints, in which fusion is inevitable, should usually be resected.

6. Amputation for septic arthritis is rarely justified, but may at times be life saving.

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