Why muzzle control is important (thanks, Xavierbreath!)

[Preacherman]

Our respected fellow THR'er, Xavierbreath, has posted on his blog a link to a picture showing exactly why muzzle control and awareness of where your gun is pointed are so important.

To see the results of inattention, click the link below.

WARNING: EXTREMELY GRAPHIC IMAGE! DO NOT OPEN IF YOU ARE SQUEAMISH, OR AT WORK!


Photo

 

[Dionysusigma]

... ugh...

If you like to carry your AR-15 on a tactical sling pointed at the ground, be aware of your feet.

Was it XB, or who?

 

[Azrael256]

Wow, that is quite a reminder. Gah! I wonder if he lost that foot.

I am really very curious about just what did that. It's an astoundingly large hole. The flesh missing from all around the fibula makes me very curious. There also doesn't seem to be a whole lot of bone damage. It doesn't look healthy, but neither leg bone looks like it was broken. Shotgun, maybe?

Anybody with some experience have an idea?

 

[Dionysusigma]

Bone? I thought that the lower thing near the bottom of the hole was the Achilles tendon... And there is something hanging out in midair that apparently got severed. I dunno.

I doubt if the foot survives, though.

 

[Norton]

Thanks for the reality check on my safety is the most important thing

 

[Preacherman]

Azrael, don't forget the effects of muzzle blast - the gases at very close range can blow a pretty big hole on their own, much larger than the wound made by the bullet. Also, I suspect the injury shown in the photograph has been "debrided" - cleared of all pulped, mashed tissue, and left with only that tissue that might heal up. So, the original bullet/gas wound wouldn't have looked quite so spectacular, IMHO.

Finally, if that was a .223 bullet, particularly a "varmint" type round or hollow- or plastic-point, it would expand very explosively on impact, and take out large chunks of flesh. In a hit like this, those chunks would simply be blown out the other side . . .

 

[redneck2]

bet that leaves a mark

If that doesn't get your attention nothing will

 

[Azrael256]

The thought had occured to me that some work had already been done on the wound, but I wasn't sure. I haven't seen a close-in shotgun wound, and I haven't seen a wound that looked that awful, so it made sense at the time. I hadn't though about muzzle blast causing that much damage, but I've only seen photos of point-blank hits, and they were all smaller handgun rounds.

I have seen a few other wounds up close, but all of them looked much neater. None of them really gave the stripped-to-the-bone impression that this one does. Even an accidental amputation doesn't seem so bad in comparison. It certainly drives home the point that this guy isn't going to walk right ever, and it only took an instant of poor gun handling to cause it.

 

[cracked butt]

I've seen that picture maybe a year ago. I'm 99% sure its a shotgun wound. Notice all of the small wounds around the big one? That be individual bits of shot. I've never seen a close up shotgun wound in real life, but I have seen what a 1/2 dozen BBs look like embedded in skin after a pheasant hunting accident (no it wasn't me that got shot, and it wasn't anyone from my group that did the shooting).

 

[Leatherneck]

Oh my. I sure hope that guy was securely in the arms of morpheus.

TC

 

[Double Naught Spy]

Bone? I thought that the lower thing near the bottom of the hole was the Achilles tendon

Right. The Achilles is there and connecting with the back of the heel. It looks like maybe the fibula lost an inch or so. That is what appears to be sticking out in the middle from the left (proximal) side.

Why villify the .223 when this happens with other rounds as well? As noted and given that the wound is already in process of being cleaned and tissue removed, there is no telling what made the wound based on the image provided.

I did not find the image on the BLOG page posted or in the last 4 months I checked. I was hoping there was the story on how this was the result of poor muzzle discipline versus just somebody who had been shot in the ankle for whatever reason.

 

[Preacherman]

I did not find the image on the BLOG page posted or in the last 4 months I checked.

DNS, try the entry for Friday, June 9 - I've attached a link to the specific post.

 

[XavierBreath]

This is not a wound I worked on, but rather a photo that was emailed to me by a nonprofessional friend. Here's my understanding of the wound pictured.........
The weapon was a .223. The wound is post surgical, after significant debridement. The white areas inside the wound appear to be laps/gauze to prevent bleeding. The lower band is the Achillies tendon. The fibula also appears to be shattered. The tibia appears to be intact. I would expect a tourniquet to be present above this wound.

What is odd to me is this appears to be an injury that just occured. looking at the smears on the foot, this injury just recieved external fixation. This appears to be an ER or surgical photo to me. It seems strange that this much debridement would have been done that soon with no attempt to save the traumatized tissue. I have cared for, and debrided gunshot wounds, and you do lose a good bit of tissue to the effects of the blast. The compression and expansion of the tissues as the shock wave travels around the wound channel can be devastating. The thing is, the damage shows up days later, and you try to save all you can. That apparently is not what happened here.

There is a high likelihood of loss of limb here, but without a consent, most surgeons would not amputate. Thus, there may be an attempt to save what cannot be saved. As a result, necrosis will likely set in soon. I suppose there is a remote possibility of saving the foot through skin and blood vessel grafts, but I do not know if the risks to the patient would be worth the small chance of success. Truly, if this were my son, I would advise amputation. I think the best overall chances here involve amputation. Sometimes you must cut your losses.

 

[Dionysusigma]

I think the best overall chances here involve amputation. Sometimes you must cut your losses.

I hope to God that wasn't a joke.

 

[XavierBreath]

Unfortunate choice of words......... Still probably the best over all choice. This man could be walking on a prosthesis in a month or still be trying to save a foot in a year. If the foot necroses, creates osteomylitis, he could lose his entire leg. If it goes septic, he could lose his life. Sometimes the best option is the one we want least.

 

[MachIVshooter]

I'm not a doctor, but looking at the photo would suggest that medical care was prompt and the coloration of the foot seems to indicate there was a decent blood supply post injury. With the Achilles still in tact and the tibia appearently OK, I'd say this fellow may have a pretty good chance at keeping his foot so long as infection does not set in. But I'm sure he'll limp for the rest of his life.

 

[shattered00]

Is "muzzle control" a phrase for "where the gun is pointed?"

Would a flash suppressor minimize the amount of damage that a muzzle blast would wreak upon the flesh? I know the energy from the blast still has to be dissipated somewhere, but I just thought I would ask.

Why does the muzzle blast do so much damage? I obviously have ideas, but I wanted to get a pretty technical answer.

How can you tell what damage to his foot is from the muzzle blast, and what is from the bullet itself?

 

[robert garner]

Why does the muzzle blast do so much damage?

The expanding gasses are capable of propelling a projectile up to near 4,000
feet per second! Whats that in miles per hour?
Supposedly the Brits figured out an effective means of suicide. Remove the bullet place muzzle under chin and set her off.
In one of Col. Coopers books he relates being first on a suicide scene, nothing remained of the mans head above the hinge of the jaw, the bullet was standing on the mantle.

 

[Lucky]

Does powder burn that well without pressure?

 

[Maser]

A .223 did that? And to think I almost got shot in the foot by a bolt action .223. Now I know what it would have looked like. Thank God my friends and I kicked that idiot out of our shooting club.

 

[Librarian]

Fascinating picture!

Looks like he lost the fibularis muscles and tendons, the posterior tibial artery and the peroneal artery; the anterior tibial artery is probably what is keeping the color in the foot - it's pretty big.

That white lump to the right, in the hole, is probably the top of the talus bone - the end of the fibula, before it was broken off, would rest on that bone, on the side the picture was taken from. The tibia rests on the outer side of the same bone (away from the camera), and I don't see the contact; maybe the tibia is displaced upward/forward, maybe the end is broken off that, too. I begin to think perhaps it is - there's a small white 'bar' just across the hole from the white lump; it seems to be on the near side; that may be the end of the fibula. The lower, more rightward structure might be part of the tibia - it seems farther away from the camera, where the tibia ought to be.

That does look like right after the fixation - they probably wouldn't bother if they didn't think it could possibly be rebuilt. I wonder how that turned out. The ankle would certainly be unstable without the muscles at the sides. I would expect the doctors might recommend a below-knee amputation, for all the reasons XavierBreath gave.

(Lessee: Ineffective Coping, Disturbed Body Image, Ineffective Tissue Perfusion - Peripheral, Impaired Walking, Risk for Falls, Ineffective Denial, Decisional Conflict, Anticipatory Grieving, Hopelessness, Impaired Physical Mobility, Acute Pain, Risk for Infection, Risk for Post-trauma Syndrome, Impaired Skin Integrity...)