Arrow Shot Injuries: Experience in a Referral Centre in North Eastern Nigeria

ABTRACT Background: Arrows are one of the most common weapons in sub-Saharan Africa readily deployedin conflicts. Injuries from arrow shots are underreported though conflicts are being seen increasingly. Aim: To review the incidence and propose guiding principles for arrow retrieval procedures. Patients and Methods: The study is a prospective review of all patients with arrow shot injuries managed at the General SaniAbacha Specialist Hospital Damaturu, Yobe State, north eastern Nigeria between January 2012 and December 2013. Result: Thirty-three patients comprising 31 males and 2 females were studied. The male to female ratio was 15: 1 and the mean age was 27.3 SD 14.8 (range 3-60 years). The peak age of incidence was 10-19 (27.3 %). Twenty-seven (81.8 %) patients were aged less than 40 years. The main reasons for attacks were conflicts between farmers and herdsmen 17 (51.5 %) and cattle rustling 7 (21.2 %). A total of 59 arrows were extracted of which 17 were multiple with a maximum of 4 arrows in one patient. The trunk 33 (55.9 %), limbs 17 (28.8 %) and head and neck 9 (15.3 %) were the main sites affected. Arrow extraction and wound debridement, extraction with thoracostomy tube drainage and laparotomy with visceral repair were the main operative procedures performed. There was no mortality and the mean hospital stay was 13 days. Conclusion: Arrow shot injuries still exist in developing societies and pose considerable challenges in their management, however with adequate resuscitation and adherence to the proposed principles for extraction the outcome is good.