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Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco General Hospital,
San Francisco, California, U.S.A.
The wounding potential and mechanisms of tissue dam- Internal ballistics describes projectile flight within the
age of firearms are reviewed. Internal ballistics is the weapon. Despite advances in bullet design and the in-
study of projectile flight within a firearm while external troduction of more powerful and fully automatic
ballistics describes projectile flight through air to the tar- weapons, firearms continue to operate on long-estab-
get. Terminal ballistics characterizes the final effects of lished principles (1). The firearm is loaded with a car-
the bullet after it has impacted its target. Upon impact, tridge that contains explosive primer, gunpowder, and
three tissue phenomena are noted: sonic wave forma- the bullet. After the trigger is released, it drives a firing
tion, temporary cavitation, and permanent cavitation. pin into the cartridge which contains the primer at its
Subsequent tissue damage is dependent on the charac- base. The spark created by this process ignites the gun-
teristics of the firearm that fired the projectile (e.g. rifle powder, which then propels the bullet down the barrel.
versus handgun), the nature of the projectile itself (e.g. During its path in the barrel of the weapon, the bullet
fully jacketed versus expanding bullet), and the attrib- begins to spin as it traverses grooves machined into the
utes of the target tissue (e.g. tissue elasticity). barrel. These grooves are termed the ‘rifling’ of the
weapon.
Keywords: ballistics, firearms, bullets, gunshot There are three basic determinants of the exit veloci-
wounds ty of the bullet. The first determinant is the mass of the
bullet: the greater the bullet’s mass, the harder it is to
propel with the same amount of gunpowder (2). The
second determinant is the amount of gunpowder in the
Introduction cartridge: the larger the amount of gunpowder, the
greater the explosion. ‘Magnum’ versions of weapons
Ballistics is the study of the firing, flight, and effects of are those which utilize a bullet of the same size and
projectiles. It may be classified into three subgroups: in- weight, but contain more gunpowder (3). The amount
ternal ballistics, or the study of projectile firing; exter- of gunpowder placed in a cartridge is limited, howev-
nal ballistics, or the description of projectile flight; and er, to the strength of the barrel and the amount of recoil
terminal ballistics, or the science of the projectile effect produced (excessive recoil may make a weapon diffi-
on the target. There are many variables that describe the cult to use) (4). The final determinant of muzzle or exit
wounding potential of firearms, including weapon type velocity is the length of the barrel. As soon as the bullet
and design, bullet type, and target tissue characteristics. exits the firearm, the gaseous pressure that propelled it
forward quickly dissipates. The bullet then decelerates
as it faces the effects of atmospheric drag (1). This is one
of the reasons that rifles, with their longer barrels, are
1 Abstracts in German, French, Italian, Spanish and Japanese able to attain significantly higher velocities than hand-
are printed at the end of this supplement. guns.
Favjo and Miclau: Ballistics and tissue wounding S-Cl3
Line of
Yaw angle 2
Fig. 1: Yaw is the angle between the long axis of the bullet and its path of flight. In this figure, the yaw angle is
exaggerated for illustrative purposes. It typically averages 1-3 degrees for most bullets travelling through air (6).
Injury 1997, Vol. 28, Suppl. 3
S-Cl4
I -
I ?A32 mm NATO
Vet-2830
Wt-15Ogr
fh, (ES2 mts)
(0.72m) FMC
Psrmenent Csvity
Fig. 3: Wound profile (lo), created by firing a 7.62 mm NATO full metal jacketed bullet at 2830 feet/second into or-
dinance gelatin. Note the yaw of the bullet to 90 degrees in tissue, then coming to rest at 180 degrees to its entry path.
This tumbling markedly increases the dimension of the permanent cavity. Another factor in wounding is that the
depth of maximal yaw, 28 cm in this case, may occur after the bullet has already passed through a thin target, such
as a human body struck directly anteriorly, or a limb. Also note the radial expansion of the temporary cavity around
the bullet path.
Favjo and Miclau: Ballistics and tissue wounding S-Cl5
such as lung will easily accommodate the stretching cre- low velocity, the distinction is quite vague, with values
ated by the temporary cavity. Other, less elastic struc- ranging from 1100 to 2500 feet/second (2, 11). Most
tures, such as liver, or a structure contained by an in- rifles generate muzzle velocities greater than 2500
elastic tissue, such as the brain, may be seriously dam- feet/second. These high energy weapons are designed
aged by this wave. Investigators have shown that a tem- to be held with both arms, thereby increasing their tol-
porary cavity produced in close proximity to bone can erable recoil energy limit. An M-16 military rifle, for ex-
cause it to shatter and propel many ‘secondary missiles’, ample, generates a velocity of 3,240 feet/second for a 55
thereby increasing tissue damage in a fashion similar to grain bullet (20). Rifles have increased wounding pow-
the permanent cavity (18). er, increased accuracy at long distances, and the capac-
Due to the variability of damage secondary to the tem- ity for high speed automatic fire. These benefits are at
porary cavity, clinical judgment must be utilized in de- the expense of difficulty in concealment because of in-
termining the actual extent of tissue damage. For the creased weight and size and increased recoil which
most part, the surgeon should concentrate on tissues makes them harder to shoot.
that are clearly not viable and perform a re-exploration Handguns are the least powerful of the firearms. Be-
of the tissues that may have been injured by secondary cause of their shorter barrels, they have decreased ve-
effects. Certainly, with the often massive size of the tem- locity, kinetic energy, and accuracy when compared to
porary cavity produced by modern day firearms, exci- rifles. Typically, the maximum velocity attainable is ap-
sion of the entire cavity is not only unwarranted, but proximately 1,500 feet/second (20). ‘Caliber’ refers to
also is often impossible (19). the diameter of the bullet, in thousandths of an inch.
Hence, a ‘.357 magnum’ fires a 0.357 inch diameter pro-
jectile at 1450 feet/second, a higher velocity than a stan-
Firearm types dard .357 handgun. Handguns are available in two main
designs - revolvers and pistols. Revolvers have a cylin-
There are three basic types of firearms: rifles, handguns, der which usually holds six cartridges and requires re-
and shotguns. Rifles are the most powerful and are peated pulling of the trigger to fire the weapon - the
known for their longer barrels and higher velocities hammer is cocked either manually (single action) or au-
when compared to handguns. While great emphasis has tomatically by pulling the trigger (double action). Au-
been placed on the classification of a weapon as high or tomatic pistols contain a magazine of cartridges which
Bullet hatlmsnts
cm
mporaty Cevtty
Fig. 4: Wound profile of a soft-point version of the 7.62 mm NATO bullet shown in Figure 3, fired at a similar ve-
locity (10). Note the massive increase in permanent cavity formation caused by bullet deformation and fragmenta-
tion. The maximum dimension of this cavity is also formed much closer to the surface, 14 cm versus 28 cm, than the
fully jacketed bullet.
Injury 1997, Vol. 28, Suppl. 3
S-Cl6
typically holds 9 to 19 rounds and can be fired by re- officials in situations where innocent bystanders near
peatedly pulling the trigger. Handguns are favored in the target victim may be endangered by passing of the
urban warfare because they are easily concealed and are bullet through the intended target. Little is known about
effective at short ranges; most shootings occur within the risk of in-vivo retention of undetonated exploding
7 yards of the target person (20). bullets; however, extreme care must be taken during
Shotguns, depending on the range from the target and their removal because simple manipulation can cause
the size of the pellets fired, may cause minor to massive them to detonate (22).
damage. A shotgun shell consists of a cylinder with
primer and gunpowder at its base. The projectile por-
tion of the shell, the pellets, are separated from the gun- Concluding remarks
powder by plastic or cardboard wadding. This wadding
can frequently be found in wounds inflicted at short The primary factors in tissue wounding include the
range. Shotguns are classified by ‘gauge’, which indi- amount of kinetic energy delivered to the subject and
cates the weight of the pellets fired by the weapon in tissue-bullet interaction. Sonic waves produced by pro-
fractions of a pound. For example, a 12-gauge shotgun jectile impact do not significantly affect most organ sys-
shoots pellets that weigh 1/12th of a pound each. The tems. The size of the permanent cavity produced, which
barrel of a shotgun is smooth and is constricted by a is the most significant component of tissue damage, de-
‘choke’ on the muzzle which narrows the exit diameter pends on bullet energy, tumbling, expansion, and frag-
and therefore helps decrease the spread of the pellets in mentation within the target. The temporary cavity pro-
flight. ‘Sawing off’ the end of the shotgun serves both duced by bullet impact can be large, but for most elas-
to increase the spread of the shotgun pellets for use in tic tissues causes only minor damage.
close-range combat and to make the weapon easier to Of the three basic firearms, rifles have the greatest
conceal (21). wounding capacity at long distances. Shotguns are ca-
pable of producing massive wounds at close ranges.
Handguns, particularly with the advent of deforming
Bullet design and fragmenting bullets, can also induce massive
wounding and can be easily concealed.
As noted above, bullet interaction with tissue plays a Future research in ballistics will include the mathe-
major role in determining the wounding capacity of any matical and statistical modelling of bullet flight and tis-
given firearm. Military bullet design is governed by the sue damage, the characterization of the true injury
Hague Convention of 1899 which mandated that these caused by the temporary cavity and sonic waves, the
bullets be surrounded by a full metal jacket (1). This jack- further study of alternative projectile systems (such as
eting consists of a hard metallic outer coating, such as fragmentation devices), the definition of the biological
copper, which surrounds the softer inner bullet which response to projectile wounding, and the continued
consists of lead. This allows for higher weapon veloci- evaluation of the newest available firearms in modern
ties, since unjacketed lead cannot be fired faster than day civilian and military warfare (17,24,25).
2000 feet/second because of stripping of the lead with-
in the barrel of the gun (5). Because of the jacketing, these
bullets will not fragment in tissue as much as an un-
jacketed bullet. Bullets available to civilians, however,
do not have to be jacketed. Because bullet fragmenta- References
tion can have a significant adverse effect on tissue, it is
1. Barach E, Tomlanovich M, Nowak R. Ballistics: a patho-
often quite possible to see much more devastating physiologic examination of the wounding mechanisms of
wounds with weapons fired from civilian firearms firearms: Part I. J. Trauma 1986;26:225-35.
(Fig. 4).
2. DeMuth WE, Jr. Bullet velocity as applied to military rifle
Bullet manufacturers have introduced new bullet de- wounding capacity. J. Trauma 1969;9:27-38.
signs which are designed to either deform or fragment
3. DeMuth WE, Jr. Ballistic characteristics of ‘magnum’
within the target. These designs provide maximum de- sidearm bullets. J Trauma 1974;14:227-9.
liverance of kinetic energy and increase in the size of the
4. DeMuth WE, Jr. Bullet velocity and design as determinants
permanent cavity. Hollow-point bullets expand to dou-
of wounding capability: an experimental study. J. Trauma
ble the bullet diameter on impact (22, 23). Shot shells 1966;6:222-32.
such as the ‘Glasser Safety Slug’ contain pellets in the
5. Hollerman JJ, Fackler ML, Coldwell DM, Ben-MenachemY.
bullet tip which disintegrate upon impact. Bullets such Gunshot wounds: 1. Bullets, ballistics, and mechanisms of
as the ‘Devastator’ (utilized in the President Reagan injury. Am. J. Roentgenol; 1990;155:685-90.
assassination attempt) explode upon impact and can 6. Fackler ML. Wound ballistics. A review of common mis-
produce massive internal damage. The Safety Slug and conceptions JAMA 1988;259:2730-6 [published erratum
Devastator were developed for use by law enforcement appears in JAMA 1988 9;260(22): 32791.
Farjo and Miclau: Ballistics and tissue wounding S-Cl7
Cheng XY, Feng TS, Liu YQ, et al. Wounding properties of 25. Peters CE, Sebourn CL. Wound ballistics of unstable pro-
steel pellets with different velocities and quality on soft tis- jectiles. Part II: temporary cavity formation and tissue
sue of dogs. J. Trauma 1988;28:S33-6. damage. J. Trauma 1996;4O:S16-21.
Swan KG, Swan RC. Principles of ballistics applicable to
the treatment of gunshot wounds. Surg. Clin. North Am. Address for correspondence:
1991;71:221-39.
Theodore Miclau, M.D., San Francisco General Hospi-
Harvey E, Korr I, Oster G, McMillen J. Secondary damage tal, 1001 Potrero Avenue, 3A36, San Francisco, CA94110
in wounding due to pressure changes accompanying the
USA
passage of high velocity missiles. Surgery 1947;21:
218-239.
10. Fackler ML, Bellamy RF, Malinowski JA. The wound pro-
file: illustration of the missile-tissue interaction. J. Trauma
1988;28:S21-9.
11. Fackler ML. Gunshot wound review. Ann. Emerg. Med.
1996;28:194-203.
12. Harvey E, McMillen J. An experimental study of shock
waves resulting from the impact of high velocity missiles
on animal tissues. J. Exp. Med. 1947;85:321-328.
13. Suneson A, Hansson HA, Kjellstrom BT, Lycke E, Seeman T.
Pressure waves caused by high-energy missiles impair res-
piration of cultured dorsal root ganglion cells. J. Trauma
1990;30:484-8.
14. Suneson A, Hansson HA, Seeman T. Peripheral high-
energy missile hits cause pressure changes and damage to
the nervous system: experimental studies on pigs. J. Trau-
ma 1987;27:782-9.
15. Suneson A, Hansson HA, SeemanT. Pressure wave injuries
to the nervous system caused by high-energy missile ex-
tremity impact: Part I. Local and distant effects on the pe-
ripheralnervous system- a light and electron microscopic
study on pigs. J. Trauma 1990;30:281-94.
16. Suneson A, Hansson HA, Lycke E, Seeman T. Pressure
wave injuries to rat dorsal root ganglion cells in culture
caused by high-energy missiles. J. Trauma 1989;29:10-8.
17. Peters CE, Sebourn CL, Crowder HL. Wound ballistics of
unstable projectiles. Part I: projectile yaw growth and re-
tardation. J. Trauma 1996;4O:SlO-5.
18. Amato JJ, Syracuse D, Seaver PR, Jr., Rich N. Bone as a sec-
ondary missile: an experimental study in the fragmenting
of bone by high-velocity missiles. J. Trauma 1989;29:609-
12.
19. Fackler ML. Wound ballistics: the management of assault
rifle injuries Mil. Med; 1990;155:222-5 [published erratum
appears in Mil. Med. 1990;155(9):A13].
20. Barach E, Tomlanovich M, Nowak R. Ballistics: a patho-
physiologic examination of the wounding mechanisms of
firearms: Part II. J. Trauma 1986;26:374-83.
21. Ordog GJ, Wasserberger J, Balasubramaniam S. Shotgun
wound ballistics. J. Trauma 1988;28:624-31.
22. Sykes LN, Jr., Champion HR, Fouty WJ. Dum-dums, hol-
low-points, and devastators: techniques designed to in-
crease wounding potential of bullets. J. Trauma 1988;
28:618-23.
23. Berlin RH, Janzon B, Liden E, et al. Terminal behaviour of
deforming bullets. J. Trauma 1988;28:S58-62.
24. Wang Z. The past, present, and future of wound ballistics
research in China. J. Trauma 1996;4O:S46-9.