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Article |

Wound Ballistics-Reply

Martin L. Fackler, MC
JAMA. 1988;260(22):3279. doi:10.1001/jama.1988.03410220061027.
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In Reply.—  Dr Adams' calculations do not support his contention that by "size" Amato et al meant area instead of diameter. The area of the 70.4-mm diameter cavity (11 sphere diameters of 6.4 mm each) is 3892 mm2, not 972 mm2. Rather than 30-fold, this is a 122-fold difference. If they did mean area, Amato et al erred even more in interpreting their data than I stated.Clearly, the majority of uncomplicated extremity gunshot wounds can be safely managed by simple means. The article by Marcus et al was cited because it implies that only low-velocity gunshot wounds can be handled this way. The initial information given about a shooting (weapon, bullet, and range) is notoriously inaccurate on the urban battle-field of our larger cities. Drs Marcus and Blair's thesis that "an analysis of the history of the injury [is] mandatory to arrive at the appropriate treatment" would


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