Shotgun “12/20 burst” injuries to the upper limb

Summary Barrel explosions (or “bursts”) can occur when different gauge cartridges are inadvertently placed into the breech of a shotgun. This article describes two cases in which injuries were sustained to the left hand and forearm as a result of the placement of 12- and 20-gauge cartridges into 12-bore shotguns. Although the incidence of catastrophic barrel failure and the injuries they cause are not known, there is concern that such cases may be increasing as the use of 20-gauge shotguns is becoming more popular. The unusual nature of this type of injury has not been described in the medical literature.