Tuesday, September 10, 2013

Author Question: Gunshot Wounds



I’m happy to have award-winning author Jocelyn Green return to Redwood’s with a couple of questions about gunshot wounds.

Welcome back, Jocelyn!

Jocelyn asks:

I decided not to do a gunshot to my character’s shoulder because of all the bones and major things it could have hit. Too complicated for my story. Instead, I am writing that she was shot through her bicep, missing the bone, though. A year later, she raises a gun for the first time since her injury, to do target practice.

Is it possible that due to nerve injury, her aim is off, or she can’t raise the gun properly? It would be great if something doesn’t look right to her “instructor.” So, can we limit her range of motion or something, due to her injury? The year is 1863, by the way, and according to my medical textbooks from that time, the treatment of a gunshot wound was to clear out the debris and just put water dressings over it.

Jordyn says

Yes, this is possible. A gunshot wound through the bicep could injure the musculocutaneous nerve that is responsible for part of the upper arm like the flexor muscles. Flexor muscles decrease angles at joints like the elbow. So, if her arm would need to be slightly bent to shoot the weapon, she would be unable to do that. That being said—if it were needed that the opposite be true (for instance her arm would need to be straight to shoot the weapon) you could injure a nerve that supplies the extensor muscle—which decreases the angle at joints like the elbow. You can view the two links below for detailed information about flexor and extensor muscles. 



Remember, though, she would exhibit these deficiencies all the time—not just when she’s learning to shoot the weapon with her instructor so that would need to be written into the story as well.

Jocelyn asks:

I also have another character who broke his arms and legs in an accident on a ship under construction. How long would he be in slings for his arms and casts for his legs? How long would he use a wheelchair or cane?

Jordyn says:

Wow! You are really torturing your poor characters in this novel! Those are very significant injuries. Bones can take anywhere from four weeks (on the short end) to eight weeks (on the long end) to heal. In the time era your novel is set in—I’m doubtful they would have done plating, screws, etc for stabilizing fractures but likely did externally set them. 

I think he’s going to be wheelchair bound for a long time. A person quickly loses muscle mass and strength in a few short weeks of being immobile so even when he’s out of his casts (in say six to eight weeks) he would not be able to tolerate a lot of physical activity for likely several months.

These days a person who suffered these injuries might be in a rehab center for several weeks building their strength and mobility back up.  

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 A former military wife, Jocelyn Green authored, along with contributing writers, the award-winning Faith Deployed: Daily Encouragement for Military Wives and Faith Deployed . . . Again. Jocelyn also co-authored Stories of Faith and Couragefrom the Home Front, which inspired her first novel: Wedded to War. She loves Mexican food, Broadway musicals, Toblerone chocolate bars, the color red, and reading on her patio. Jocelyn lives with her husband Rob and two small children in Cedar Falls, Iowa.

2 comments:

  1. You surprise me with your estimates of how long bones take to heal. I did my tibia when I was almost 16, and they told me it would take 8 weeks to be out of plaster, and another four on crutches before it was completely healed - and they said that was because I was young and it would be longer for an adult. In the event it was four more weeks that they said - 12 whole weeks in plaster. So I'm surprised to hear you say 8 weeks is the longest.

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    1. Hi Carrie,

      Thanks for leaving your comment. Keep in mind-- orthopedic practices have advanced quite a bit in the last number of years.

      For instance-- just your comment of saying "plaster" makes me think this injury was over 15 years ago. I don't see plaster used for cast making at all. It's generally fiberglass material.

      Let's take a femur fracture that used to be pinned and the patient was in traction. Now, they can put a rod up in through the center of the bone. And you know what they say-- you "can" walk on it because it is stronger than what you had before but you won't want to because the bones do need to heal and it will be too painful.

      Some simple fractures in kids we literally put a simple brace on and not a cast because they will self splint until it feels better. Ortho is going this directions. Walking boots instead of full casts.

      So-- I do stick by this based on the changes in orthopedics over the last 20 years but thanks so much for sharing your insight.

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