Ballistic Injuries among Civilians during the June 2023 Protests in Senegal: Epidemiological, Diagnostic and Therapeutic Aspects

Title: Gunshot injuries during the June 2023 protests in Senegal: Epidemiological, diagnostic, and therapeutic aspects at Idrissa Pouye General Hospital (HOGIP). Background: Political protests in June 2023 in Senegal led to an unprecedented influx of ballistic trauma in civilian settings. The aim of this study was to describe the management of these injuries at the Orthopedics-Traumatology department of the HOGIP in Dakar. Materials and Methods: This was a retrospective descriptive study conducted over 5 days (June 1-5, 2023). All civilians admitted for ballistic trauma were included, excluding isolated cranial or abdomino-pelvic injuries. Results: Sixty (60) patients were included, all male, with a mean age of 26.9 years. Injuries were predominantly located in the limbs (95.59%), particularly the lower limbs (61.76%). Open fractures occurred in 23.53% of cases, mainly affecting long bones (humerus, femur, and tibia). Imaging confirmed the presence of live ammunition or metallic fragments in 20.59% of cases. Surgical treatment was performed for 84.84% of lesions, primarily involving debridement (39.39%) and external fixation (15.15%). Conclusion: The June 2023 protests resulted in complex ballistic injuries among young men. HOGIP played a vital role in emergency response. The “damage control” strategy, based on surgical debridement and external fixation, was essential to stabilize severe injuries. This study highlights the need for urban hospitals to maintain constant preparedness (e.g., “Plan Blanc”) for mass casualty events. Prohibiting the use of lethal ammunition for crowd control is a public health necessity to prevent life-altering disabilities.