ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Ballistic limb trauma: lessons from a decade of french civilian and military experience.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBallistic limb injuries are increasingly encountered in both civilian and military settings, yet robust collaborative cohorts remain limited.
methodsWe conducted a retrospective, multicenter study across six French trauma centers (three civilian, three military) from 2014 to 2022, including consecutive patients aged ≥ 16 years with ballistic limb injuries. Data collected included demographics, context (civilian vs. combat/terror), projectile type and velocity, lesion characteristics, and early management. The primary outcome was early surgical site infection (SSI, < 30 days). Secondary outcomes were late and persistent infection, reoperations, fracture union, and infection-free survival. Univariate tests and multivariable logistic regression identified predictors of early SSI; Kaplan–Meier analysis assessed infection-free survival after initial infection.
resultsAmong 254 patients (mean age 33.3 ± 12.7 years), 238 (93.7%) were male and 203 (79.9%) were civilian cases. Bullets caused 178 injuries (70.1%), pellets 47 (18.5%), and fragments 29 (11.4%); 43 injuries (16.9%) were high-velocity. Lower limbs were affected in 127 cases (50.0%), and 136 patients (53.5%) had open fractures, including 33 (13.0%) Gustilo III. Damage-control orthopedics was applied in 98 patients (38.6%), and immediate skin closure in 153 (60.2%). Early SSI occurred in 42 patients (16.5%), late infection (> 30 days) in 26 (10.2%), and persistent infection at last follow-up in 12 (4.7%). On multivariable analysis, higher SAPS II (aOR 1.075 per point; 95%CI 1.00–1.15; p = 0.040) and leg fractures (aOR 16.82; 95%CI 1.6–176; p = 0.018) independently predicted early SSI (AUC 0.872). Among 42 patients with postoperative infection, 8 (19.0%) evolved toward persistence; restricted mean infection-free survival was 64.3 ± 6.1 months, with no median reached. Military injuries more often involved high-velocity projectiles, fragments, and damage-control or reconstructive strategies.
conclusionIn this large French civilian–military cohort, early SSI affected one in six patients. Physiological severity and leg fractures were independent predictors. Despite frequent early infections, long-term persistence was uncommon, supporting early physiological optimization and fracture-centered strategies in ballistic limb trauma. LEVEL OF EVIDENCE: IV.
Indexed as
Identifiers
41801287What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.