How can a bullet enter the shoulder and exit at the hip?


Usual Answer:

Bullets bounce off bones taking unexpected paths within the body.

Textbook example we’ve loved: The bullet travels along the inner curvature of a skull.


Kinematics lectures are filled with images like this one where

anatomical man poses for assault in perfect posture.


Shot in the shoulder, the bullet bounces along ribs and pelvis and exits the hip.

Mmmm Hmmm.

When a patient has two penetrating injuries at the shoulder and hip, it’s likely that the victim was

shot twice


abandoned the anatomical position and assumed one more like this:


The US sees more blunt than penetrating trauma thanks to motor vehicle collisions.
Thus our analysis of blunt MOIs is well practiced.

When mentally reconstructing the forces applied to your patient with high-velocity penetrating trauma, consider the position they may have been in during the event.

Remember, if they knew the bullet was coming, they weren’t standing like this:


More to follow.

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