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One hundred and one patients who sustained gunshot wounds to their feet were retrospectively reviewed. All patients were treated at King/Drew Medical Center between 1982 and 1994. From the authors' experience, they believe that patients with low-velocity gunshot wounds to the foot should be hospitalized and treated with at least a 3-day course of intravenous antibiotics of a first generation cephalosporin. Low-energy shotgun injuries should be treated the same as low-velocity injuries. Patients with high-velocity and high-energy shotgun wounds should be hospitalized and receive broad-spectrum intravenous antibiotics with multiple irrigation and debridements.

Between 1989 and 1993, 67 fractures of the knee secondary to gunshot wounds were treated at the King/Drew Medical Center in Los Angeles, California. Based on this experience, a treatment protocol was devised. The protocol addresses the evaluation and management of neurovascular injuries, soft-tissue wounds, and fractures. These concepts are summarized in an algorithm.