Okay, but, because I'm a dunce, why can't I have the shot break her pelvis instead of her femur? You said the caliber mentioned wouldn't be enough to break it enough to need stabilization. A. I don't actually have to mention the caliber because the POV character doesn't know guns. Would be nice to figure out just for background but doesn't have to be mentioned that I know of yet. B. I don't really want it to need major stabilization, just to take a long time to heal. A good crack would do it. That should take at least a few months before she can go running off and doing physically demanding things. Would that work theoretically?
OKaaaaaay, LECTURE MODE: ON
(If we are trying to do something that is plausible to a medical eye)
Many folks, doctors included, forget basic physics when speaking about gunshot wounds.
The issue is ENERGY, and the basic premise that it cannot be destroyed, only transferred. See
Energy Equivalence.
The way a bullet causes damage to a structure is by transferring it's energy to the object being damaged, in this case, the character. The force that is applied to the object is given by
Newton's Third Law: F=ma
How the energy is transferred is just as important as how
much. First, the object transferring the energy (the
bullet):
Think of a 20kg axe hitting a log versus a 20kg hammer hitting the same log. The axe splits the wood, in part, because all the energy is being directed to one spot. Not all the energy is even transferred, but goes into the support the log is on. The hammer applies the same force, but cannot transfer all the energy to that one spot, so the log is crushed.
In our case, the analogy might be a tipped round versus a hollow point. The idea behind a hollow point is to do more damage. How? By transferring more energy. The hollow tip expands/explodes when it hits, thereby transferring more energy, rather than just passing through. This is, of course, an oversimplification to the point of absurdity, read more
online. For example, a small round directly to the heart, brain, or large vessel may also cause death.
Now, on to the victim:
In your question, you ask why the femur, not the pelvis?
Think of the pelvis as a bony funnel, and the femur as a bony pipe. The pelvis surround many important structures. The femur is in the centre of a mass of muscle with structures that "only" supply the more distal leg.
Not only is the pelvis made out of sheets of bone, they are also attached to each other by fibrous ligaments. This means that the pelvis has a measure of "give", of resilience, built into it.
Unless we are speaking of grandma, with osteoporosis, it takes an enormous amount of energy to break a pelvis. You sometimes can have an extremely unlucky low-impact fall that will break it, but that is unusual. We are trying to create medically plausible, remember?
Don't oversimplify pelvis fractures. For example, a simple stable pelvic fracture does not usually imply much blood loss, while an unstable one is a horse of a totally different colour.
Pelvic fracture - short article. The reason why these unstable fractures cause trouble is because of bleeding from
non-bony structures, mainly pelvic blood vessels.
So, if you create a scenario where a bullet wound not only
fractures a pelvis, but also causes the doctor (early on)to think the victim is going to die ,
and to also lose a lot of blood
and cause the person to have an extended recovery
and be able to speak, you make things difficult and unlikely. And why, IMHO, "a good crack" would not do it!
You definitely need a high impact round that will transfer much of it's energy and likely cause immense damage to other things than the pelvis: venous plexuses, arteries, ureters, bladder, small bowel, large bowel. Does this make sense?
So,
any round could not only fracture the femur, but also cause immense blood loss, without causing death. It would absolutely appear life threatening under these circumstances. The recovery time would be about 6-8 weeks for initial recovery, and then another month or two for complete reconditioning.
Again, I don't need the doctor to think she will surely die and then suddenly reverse his opinion. He simply has to be very worried, given the conditions.
Any bullet wound to a complex structure will cause a doctor worth his salt to worry. A lot.
How long does it take to recover from the huge loss of blood part? Would she feel tired, short of breath, foggy, what?
Many thanks.
Depends. On: How much, how fast, how she is treated, what other injuries she has.
What you need to
steer away from is the simple: All she needs is an IV, and she will recover.
Simple IVs can actually make things worse, if not given with understanding, and if given to excess. Recently, our management of the shock caused by blood loss has changed. Significantly. Again.
We now understand that giving too much crystalloid (salty water) without accompanying it with blood products can actually make things worse. Much worse.
In recent times, we have also come to understand that other drugs, such as tranexamic acid,
if given early, can significantly improve outcomes.
Depending of the era of your novel, your doctor may or may not be aware of this.
LECTURE MODE: OFF
I hope this is not too confusing. You are sketching a scenario that could give rise to many perceived inaccuracies, so keeping things simple, yet effective, is the way to go, once again, IMHO.
HTH
CB
