Limb salvage and functional recovery following accidental shotgun injury in a young child: A case report

Background: Paediatric firearm injuries are rare in civilian settings but pose significant challenges due to high-energy trauma, small anatomical compartments, and limited physiological reserve. Shotgun wounds, in particular, produce complex skeletal and soft tissue destruction requiring staged multidisciplinary care. Case presentation: We report a 3-year-old girl with an accidental close range shotgun injury to the right forearm, presenting with grossly contaminated wounds, soft tissue loss, and comminuted fractures of the shaft of radius and ulna. Emergent debridement and elbow-spanning external fixation were performed, followed by a re-debridement at 48 h and a split-thickness skin grafting on day 10. Conclusion: This case highlights key principles in the management of severe paediatric ballistic trauma, including timely debridement and external fixation followed by relook debridement, antibiotics, and early soft tissue reconstruction. With structured rehabilitation, the child achieved fracture union and near-complete functional recovery. Early multidisciplinary intervention remains essential to optimize outcomes.