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Case Reports
. 2011 Jan;40(1):53-9.
doi: 10.1259/dmfr/72527764.

The role of maxillofacial radiologists in gunshot injuries: a hypothesized missile trajectory in two case reports

K Sansare  1 , V Khanna, F Karjodkar
Affiliations
Case Reports

The role of maxillofacial radiologists in gunshot injuries: a hypothesized missile trajectory in two case reports

K Sansare et al. Dentomaxillofac Radiol. 2011 Jan.

Abstract

Gunshot injuries are an emerging form of trauma that oral radiologists increasingly have to deal with. There are two main types of gunshot injuries: high-velocity and low-velocity bullet injuries. The outcome of high-velocity gunshot injury is usually fatal; however, a non-fatal low-velocity injury to the maxillofacial region is more likely to be encountered by the oral and maxillofacial radiologist. It is therefore important to up-to-date knowledge of ballistic science and its implications in the field of maxillofacial radiology. The ability of oral and maxillofacial radiologists to predict the missile trajectory will aid the assessment and localization of the damage caused by the bullet and its splinters. Predicting the missile trajectory may also be of help to law enforcement agencies and forensic scientists in determining the type of firearm used and direction of fire. This article, which examines two cases, attempts to highlight to the oral radiologist this emerging form of trauma and its implications.

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Figures

Figure 1
Figure 1
Panoramic view showing bullet splinters spread around the left ramus and posterior body of mandible
Figure 2
Figure 2
Posteroanterior mandible projection showing pellets around left inferior border to the subcondylar region of the mandible
Figure 3
Figure 3
CT scan showing multiple pellets in labial soft tissue involving the body and the ramus of the left side of the mandible
Figure 4
Figure 4
Projected missile trajectory of Case 1, shown on a scan of a different, non-trauma, case. A, anterior; F, foot; L, left; R, right
Figure 5
Figure 5
Panoramic radiograph showing a concentration of pellets in the right angle and body of mandible, posteroinferior border of right maxillary sinus and fractured palate (arrows)
Figure 6
Figure 6
Posteroanterior mandible projection showing pellets around the right angle of mandible and some in the soft tissue at the level of the C3 vertebra
Figure 7
Figure 7
CT scan images confirming the fracture of the right lateral pterygoid plate, pellets lingual to the right ramus area, some pellets in the right soft tissue at the level of the C3 vertebra and fracture of posteroinferior border of right maxillary sinus
Figure 8
Figure 8
Dentascan showing rounded right angle of mandible and defect in upper anterior region
Figure 9
Figure 9
Projected missile trajectory for Case 2
See this image and copyright information in PMC

References

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