Causes

The energy of the missile is dissipated into tissues of the body, causing destruction of vital and nonvital structures. When the missile enters the body, it creates a temporary cavity, which stretches, distorts, and compresses the surrounding anatomic structures. The cavity that is produced often has a greater diameter than the missile itself. In a situation called "blast effect" or "muzzle blast," damage occurs in structures outside the direct path of the missile. High-velocity missiles (bullets from shotguns, rifles, or high-caliber handguns) cause extensive cavitation and significant tissue destruction, while low-velocity missiles (bullets from low-caliber handguns) have limited cavitation potential with less tissue destruction. Another characteristic of missiles is the yaw, which is the amount of tumbling and movement of the nose of the missile that occurs. The more yaw, the greater the tissue damage.

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