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The treatment of gunshot injuries of the jaws.

Colyer describes the management of a heterogeneous group of ballistic facial injuries and as such his term ‘gunshot injuries’ is perhaps incorrect and ‘ballistic injury’ would be more appropriate. Mechanisms of injury included bullets, shrapnel, trench mortars and other explosive devices and, given this, there would be a wide range of energy transfer patterns; indeed, one patient he describes sustained an injury from a horse kick. Again, although described as jaw injuries, all the cases he presented were mandibular injuries, with no maxillary injuries mentioned. The overriding majority of patients presented late, often several months after injury, with complications including nonunion, malunion, soft tissue contraction and trismus. He describes four cases that were treated early (between 2 and 4 weeks after injury) and points out the improved functional outcome from such early care.