Gunshot wounds: A review of ballistics related to penetrating trauma

Since the introduction of the term “wound ballistics”[1,2] indicating the study of the wounding mechanisms of missiles [3], extensive experimental research on this field has beenconductedby investigators with a military background [4-7]. In the context of wound ballistics, the term missile is used to denote various types of small projectiles, such as bullets and fragments, that have enough kinetic energy to penetrate a living target[8]. Civilian gunshot injuries have been studied to a lesser extentin connection to ballistic aspects [9-10], with major contributions by two influential forensic scientists, Beat Kneubuehl [11] in Europe, and Vincent DiMaio[12] in the US. Whereas the severity of any penetrating injury is eventually related to the vicinity of the wound track to vital organs and large vessels, the nature of gunshot wounds (GSW)is influenced by the dynamics of the projectile and the local reaction of the penetrated tissue [13-16].These two aspects reflect the complex projectile-tissue interaction which takes place during the penetration process [14,17,18], accounting for the scientific approach to these injuries both from a physical (ballistic) and biological (“wound”) point of view[16]. Therefore, a complete understanding of this process requires a basicknowledge of the ballistic factors implicated in tissue wounding. This paper reviews ballistics of GSW inflicted by handgun and rifle ammunition. Shotgun injuries are not included in the Civilian gunshot injuries from handgun and rifle ammunition vary in severity depending on the anatomic location involved and the different effects from the ballistic properties of the penetrating projectiles. Ballistic factors such as the impact velocity and energy should not be considered in isolation, as their specific effects are determined by the interaction between the projectile and tissues. Increased tissue damage can result from tumbling of non-deforming rifle bullets and deformation of expanding bullets. Both of these mechanisms increase substantially the energy transfer to the wound and its diameter, also producing a pulsating temporary cavity associated with pressure changes within tissue. Journal of Acute Disease (2014)178-185